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[腹膜炎预后联合预测系统]

[Combined forecasting system of peritonitis outcome].

作者信息

Lebedev N V, Klimov A E, Agrba S B, Gaidukevich E K

机构信息

Department of Faculty Surgery, Peoples' Friendship University of Russia, Moscow, Russia.

出版信息

Khirurgiia (Mosk). 2017(9):33-37. doi: 10.17116/hirurgia2017933-37.

Abstract

AIM

To create a reliable system for assessing of severity and prediction of the outcome of peritonitis.

MATERIAL AND METHODS

Critical analysis of the systems for peritonitis severity assessment is presented. The study included outcomes of 347 patients who admitted at the Department of Faculty Surgery of Peoples' Friendship University of Russia in 2015-2016. The cause of peritonitis were destructive forms of acute appendicitis, cholecystitis, perforated gastroduodenal ulcer, various perforation of small and large intestines (including tumor).

RESULTS

Combined forecasting system for peritonitis severity assessment is created. The system includes clinical, laboratory data, assessment of systemic inflammatory response (SIRS) and severity of organ failure (qSOFA). The authors focused on easily identifiable parameters which are available in virtually any surgical hospital. Threshold value (lethal outcome probability over 50%) is 8 scores in this system. Sensitivity, specificity and accuracy were 93.3, 99.7 and 98.9%, respectively according to ROC-curve that exceeds those parameters of MPI and APACHE II.

摘要

目的

创建一个用于评估腹膜炎严重程度和预测其结局的可靠系统。

材料与方法

对腹膜炎严重程度评估系统进行批判性分析。该研究纳入了2015 - 2016年在俄罗斯人民友谊大学外科系住院的347例患者的结局。腹膜炎的病因包括急性阑尾炎的坏疽型、胆囊炎、胃十二指肠溃疡穿孔、小肠和大肠的各种穿孔(包括肿瘤穿孔)。

结果

创建了腹膜炎严重程度评估的联合预测系统。该系统包括临床、实验室数据、全身炎症反应(SIRS)评估和器官功能衰竭严重程度(qSOFA)。作者关注的是几乎任何外科医院都可获取的易于识别的参数。该系统中阈值(致死结局概率超过50%)为8分。根据ROC曲线,敏感性、特异性和准确性分别为93.3%、99.7%和98.9%,超过了MPI和APACHE II的这些参数。

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