Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study: a WSES observational study.

Area of Science:

• Emergency Medicine
• Surgical Critical Care
• Clinical Prognostication

Background:

• Effective management of acute peritonitis hinges on timely peritoneal source control.
• Early prognostic evaluation is crucial for assessing severity and guiding treatment.
• Identifying predictors of in-hospital mortality is essential for patient care.

Purpose of the Study:

• To identify clinical and laboratory predictors of in-hospital mortality in acute peritonitis patients.
• To develop a globally applicable warning score system for acute peritonitis.
• To create a bedside tool for early risk assessment.

Main Methods:

• Worldwide multicentre observational study involving 153 surgical departments in 56 countries.
• Inclusion of 3137 patients with acute peritonitis between February 1 and May 31, 2018.
• Multivariable logistic regression to identify independent predictors of in-hospital mortality.

Main Results:

• Overall in-hospital mortality rate was 8.9% among 3137 patients.
• Key predictors identified include advanced age, malignancy, severe comorbidities, respiratory rate, systolic blood pressure, consciousness level, SpO2, platelet count, and lactate levels.
• The PIPAS Severity Score demonstrated a strong correlation with mortality rates, ranging from 2.9% to 86.7% based on score categories.

Conclusions:

• The PIPAS Severity Score is a simple, bedside tool for early risk stratification in acute peritonitis.
• This score can be utilized globally to identify patients at high risk of treatment failure and mortality.
• Implementation of the PIPAS score can guide clinical decision-making and resource allocation.