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Colon Ascendens Stent Peritonitis CASP - a Standardized Model for Polymicrobial Abdominal Sepsis
Published on: December 18, 2010
[Índice de Mannheim y mortalidad en sepsis abdominal]
Luis G González-Pérez1, Yazmín Sánchez-Delgado2, Ansony R Godínez-Vidal2
1Clínica de Sepsis, Servicio de Cirugía General. Hospital General de México Dr. Eduardo Liceaga, Ciudad de México, México.
IntroduccióN:
La sepsis abdominal representa la respuesta inflamatoria peritoneal ante la invasión microbiana, con una mortalidad del 17%. El índice de peritonitis de Mannheim es una herramienta clínica y un predictor de mortalidad, con alta sensibilidad y especificidad.
Objetivo:
Determinar si existe correlación entre el puntaje obtenido mediante el índice de peritonitis de Mannheim y la mortalidad.
MéTodo:
Estudio retrospectivo, observacional, transversal, durante el periodo entre julio de 2013 y enero de 2014, en pacientes con diagnóstico de sepsis abdominal, en el Hospital General de México Dr. Eduardo Liceaga.
Resultados:
Se incluyeron 177 casos, 85 de sexo femenino y 92 de sexo masculino. La edad media fue de 43 años. El órgano causante de la sepsis abdominal más frecuente fue el apéndice. Fallecieron 18 pacientes (10.2%). Se dividieron los casos, de acuerdo con el índice de Mannheim, en leves (< 25 puntos) y graves (> 26 puntos). De 27 pacientes graves, fallecieron 8 (29.6%), mientras que de los 150 leves fallecieron 10 (6.7%) (odds ratio: 5.895; intervalo de confianza del 95%: 2.071-16.77; p < 0,05).
ConclusióN:
El índice de Mannheim es un buen predictor de mortalidad para los pacientes con sepsis abdominal. El punto de corte óptimo es 20.
Background:
Abdominal sepsis represents the host’s peritoneal inflammatory response to microbial invasion, which may be mild or severe, depending on the degree of contamination of the peritoneal cavity; with a reported mortality of 17%. The Mannheim peritonitis index is a clinical tool and a predictor of mortality in patients with peritonitis, with high sensitivity and specificity.
Objective:
To determine if there is a correlation between the score obtained by the Mannheim peritonitis index, and mortality, in patients with abdominal sepsis.
Method:
A retrospective, observational, cross-sectional study, during the period between July 2013 and January 2014, in patients diagnosed with abdominal sepsis, attended at the General Hospital of Mexico Dr. Eduardo Liceaga.
Results:
We included 177 cases, 85 of the female sex and 92 of the male sex. The average age was 43 years. The most common organ responsible for abdominal sepsis was the appendix. Mortality of 18 cases (10.2%). The cases were divided, according to the Mannheim index, in mild cases (< 25 points) and severe case (> 26 points). Of 27 severe cases, 8 (29.6%) died, while of the 150 mild cases 10 (6.7%) died (odds ratio: 5.895; 95% confidence interval: 2.071-16.77; p < 0.05).
Conclusions:
The Mannheim scale is a good predictor of mortality for patients with abdominal sepsis. The optimal cut-off point is 20.
Insights
The Mannheim peritonitis index effectively predicts mortality in abdominal sepsis patients. A score over 26 indicates severe cases with significantly higher mortality rates, suggesting its clinical utility.
Area of Science:
- Abdominal sepsis research
- Clinical prediction models
- Peritonitis management
Background:
- Abdominal sepsis is a severe inflammatory response to microbial invasion of the peritoneum.
- It carries a significant mortality rate, reported up to 17%.
- The Mannheim peritonitis index is a validated tool for assessing peritonitis severity and predicting mortality.
Purpose of the Study:
- To investigate the correlation between the Mannheim peritonitis index score and mortality in patients with abdominal sepsis.
- To evaluate the predictive value of the Mannheim peritonitis index in this specific patient population.
Main Methods:
- A retrospective, observational, cross-sectional study was conducted.
- Data from 177 patients diagnosed with abdominal sepsis between July 2013 and January 2014 were analyzed.
- Patients were categorized into mild (<25 points) and severe (>26 points) groups based on the Mannheim index.
Main Results:
- The overall mortality rate was 10.2% (18 out of 177 patients).
- Patients classified as severe (27 cases) had a mortality rate of 29.6% (8 deaths).
- Mild cases (150 patients) had a lower mortality rate of 6.7% (10 deaths), with an odds ratio of 5.895 for mortality in severe cases.
Conclusions:
- The Mannheim peritonitis index is a reliable predictor of mortality in patients with abdominal sepsis.
- An optimal cut-off point of 20 on the Mannheim scale is suggested for better risk stratification.
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