[Eritonitis outcome prediction]. / Prognoz iskhoda peritonita.

The review is devoted to the most common general clinical and specific grading systems for peritonitis outcome prediction. Particular attention is paid to methodological approaches, prediction reliability, simplicity of use in clinical practice and their importance in decision-making. It is shown that none of the modern grading systems is universal and absolutely reliable. Combining several systems is quite difficult and will take additional time that is impossible for intraoperative environment. Despite various systems for peritonitis outcome prediction, none of them can completely satisfy surgeons, primarily in choice of surgical access, intervention type and option for its completion.

[Comparative assessment of prognostic systems for secondary peritonitis outcome]. / Sravnitel'naya otsenka sistem prognoza iskhoda vtorichnogo peritonita.

OBJECTIVE: To compare the most common prognostic systems in patients with peritonitis. MATERIAL AND METHODS: The study included 352 patients with secondary peritonitis. At admission, sepsis was diagnosed in 15 (4.3%) patients, septic shock - in 4 (1.1%) cases. Mortality was associated with the following main causes: purulent intoxication and/or sepsis - 51 cases (87.9%), cancer-induced intoxication - 4 (6.9%) cases, acute cardiovascular failure - 3 cases (5.2%). We analyzed the efficacy of Manheim Peritoneal Index (MPI), WSES prognostic score, APACHE-II scale, gSOFA score and Peritonitis Prediction System (PPS) developed by the authors. RESULTS: Age of a patient, malignant tumor, exudate nature, sepsis (septic shock) and organ failure not associated with peritonitis are the most important criteria in predicting fatal outcome. ROC analysis was used to assess prognostic value of various prediction systems. Standard error was less than 0.05 for all scales. Therefore, all prediction systems can be considered accurate for prediction of mortality in patients with peritonitis. CONCLUSION: PPS (AUC 0.942) has the greatest accuracy in predicting fatal outcome in patients with advanced secondary peritonitis, APACHE II (AUC 0.840) - minimum accuracy. MPI had predictive accuracy > 90% too.