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Journal

2013 | 8 | 4 | 410-414

Article title

Prediction for a planned relaparotomy in secondary peritonitis

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EN

Abstracts

EN
Aims. To devise a scoring system for clinical variables related to positive findings at relaparotomy in secondary peritonitis. Methods. We have retrospectively studied 195 cases of patients after relaparotomy. According to the operation’s findings, the patients were divided into two groups: ‘relaparatomy unnecessary’ group A, ‘relaparotomy necessary’ group B. 6 factors (age, sex, leukocyte count, C reactive protein, time of symptoms to index operation, Mannheim Peritonitis Index) were evaluated in respect to their significance in decision making for relaparotomy. The predictive value for positive operation`s findings of these factors was evaluated by logistic multivariate regression analysis. According to this model a risk scoring system was created to support the decision whether to perform a relaparotomy. Results. Relaparotomy was unnecessary (Group A) for 154 (79,0%) patients, for 41 (21,0%) it was necessary (Group B). Comparing the groups A and B, we found a significant difference in patients’ mean age (54 v. 63 years, p=0,002), mean CRP level (133,2 v. 182,8 mg/L, p=0,025), mean time of symptoms to index operation (38,1 v. 67,1 hours, p=0,006) and mean MPI value (22,4 v. 29,4, p<0,0001). According to the above-mentioned predictors, a scoring system was devised: −0,17-(0,003×patient’s age years)+(0.153×time of symptoms to index operation hours)-(0,297×MPI)+(0,192×CRP mg/l). The score was 24,798±25,593 in group A and 36,572±32,543 in group B(p=0,028). Conclusions: Scoring system was devised to assist in creating treatment strategy after secondary peritonitis. If the score is ≥37, a planned relaparotomy should be performed. If the score is ≤24, other diagnostic and therapeutic tactics should be applied.

Publisher

Journal

Year

Volume

8

Issue

4

Pages

410-414

Physical description

Dates

published
1 - 8 - 2013
online
12 - 6 - 2013

Contributors

author
  • Center of Abdominal surgery, Vilnius University Hospital Santariskiu Klinikos, Santariskiu street 2, 08661, Vilnius, Lithuania
  • Center of Abdominal surgery, Vilnius University Hospital Santariskiu Klinikos, Santariskiu street 2, 08661, Vilnius, Lithuania
author
  • Center of Abdominal surgery, Vilnius University Hospital Santariskiu Klinikos, Santariskiu street 2, 08661, Vilnius, Lithuania
author
  • Center of Abdominal surgery, Vilnius University Hospital Santariskiu Klinikos, Santariskiu street 2, 08661, Vilnius, Lithuania
author
  • Center of Abdominal surgery, Vilnius University Hospital Santariskiu Klinikos, Santariskiu street 2, 08661, Vilnius, Lithuania

References

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Document Type

Publication order reference

Identifiers

YADDA identifier

bwmeta1.element.-psjd-doi-10_2478_s11536-013-0180-7
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