Salamone G, Licari L, Falco N, Augello G, Tutino R, Campanella S, Guercio G, Gulotta G
G Chir. 2016 Nov-Dec;37(6):243-249. doi: 10.11138/gchir/2016.37.6.243.
Acute Secondary Peritonitis due to abdominal visceral perforation is characterized by high mortality and morbidity risk. Risk stratification allows prognosis prediction to adopt the best surgical treatment and clinical care support therapy. In Western countries elderly people represent a significant percentage of population Aim. Evaluation of Mannheim Peritonitis Index (MPI) and consideration upon old people.
Retrospective study on 104 patients admitted and operated for "Acute Secondary Peritonitis due to visceral perforation". MPI was scored. In our study we want to demonstrate efficacy of MPI and the possibility to consider older age an independent prognostic factor.
Mortality was 25.96%. Greatest sensitivity and specificity for the MPI score as a predictor of mortality was at the score of 20. MPI score of <16 had 0.15 times lower risk of mortality compared to patients with MPI score 17 - 21 and 0.61 lower than patients with MPI >22. Patients with MPI score 17-21 had 0.46 times lower risk of mortality compared to patients with MPI score >21. In the group of patients with MPI score of >20 the mortality rate was 48.5% for patients older than 80 years old and 12.1% for younger patients (p < 0.005); in the group with MPI score of < 20 mortality rate was respectively 8.4% and 1.4% (p < 0.005).
Data confirm the accuracy of the test. MPI score and age over 80 years old resulted independent predictors of mortality at multivariate analysis.
因腹腔内脏穿孔导致的急性继发性腹膜炎具有高死亡率和高发病风险。风险分层有助于预测预后，从而采取最佳的手术治疗和临床护理支持治疗。在西方国家，老年人在人口中占很大比例。目的：评估曼海姆腹膜炎指数（MPI）并考虑老年人情况。
对104例因“内脏穿孔导致的急性继发性腹膜炎”入院并接受手术的患者进行回顾性研究。对MPI进行评分。在我们的研究中，我们想证明MPI的有效性以及将高龄视为独立预后因素的可能性。
死亡率为25.96%。MPI评分作为死亡率预测指标的最大敏感性和特异性出现在20分。MPI评分<16的患者与MPI评分为17 - 21的患者相比，死亡风险低0.15倍，与MPI评分>22的患者相比低0.61倍。MPI评分为17 - 21的患者与MPI评分>21的患者相比，死亡风险低0.46倍。在MPI评分>20的患者组中，80岁以上患者的死亡率为48.5%，年轻患者为12.1%（p<0.005）；在MPI评分<20的组中，死亡率分别为8.4%和1.4%（p<0.005）。
数据证实了该测试的准确性。在多变量分析中，MPI评分和80岁以上年龄是死亡率的独立预测因素。
