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曼海姆腹膜炎指数对腹膜炎术后转归的预测价值。

Mannheim's peritonitis index in the prediction of postoperative outcome of peritonitis.

机构信息

- Hospital Santa Casa de Misericórdia de Vitória, Cirurgia Geral - Vitória - ES - Brasil.

- EMESCAM, Medicina - Vitória - ES - Brasil.

出版信息

Rev Col Bras Cir. 2022 Sep 2;49:e20222991. doi: 10.1590/0100-6991e-20222991_en. eCollection 2022.

Abstract

OBJECTIVE

evaluate the effectiveness of MPI to predict mortality in patients with peritonitis in Santa Casa de Misericordia de Vitoria Hospital (HSCMV).

METHODS

a longitudinal observational cohort retrospectively study, with a sample of 75 patients diagnosed with peritonitis between January 2010 to December 2 of 2015, in HSCMV and with all the necessary criteria for the calculation of IPM.

RESULTS

we found a profile of the patients, 33 female and 42 male, mean age 42 years, 11 deaths and 14.67% mortality percentage. Comparing the MPI variables into two groups (survivors and deceased) was found that older than 50 years, presence of malignancy and patients with organ dysfunction have statistical significance for mortality, with p<0.05. The MPI ranged between 4-41 points, with average of 21.2 points. However, among the dead, the score ranged from 23 to 41, with a mean of 32.8. Therefore, the cutoff point of 27 points was established by evaluating the best value of Kappa concordance index, and through it were calculated: 90.90% sensitivity and specificity of 78.13% by the ROC curve.

CONCLUSION

based on these results, it was established that the MPI was effective in estimating the risk of death when the index reaches values = 27 points. Categorizing patients into different risk groups helps in determining a better prognosis and defining operative risk, thus contributing to the choice of the surgical procedure nature.

摘要

目的

评估 MPI 预测圣家慈悲医院(HSCMV)腹膜炎患者死亡率的有效性。

方法

这是一项回顾性纵向观察队列研究,样本为 2010 年 1 月至 2015 年 12 月 2 日期间在 HSCMV 被诊断为腹膜炎且符合 IPM 计算所有必要标准的 75 名患者。

结果

我们发现了患者的特征,33 名女性和 42 名男性,平均年龄 42 岁,11 例死亡,死亡率为 14.67%。将 MPI 变量分为两组(存活组和死亡组)比较发现,年龄>50 岁、存在恶性肿瘤和器官功能障碍的患者的死亡率具有统计学意义,p<0.05。MPI 范围为 4-41 分,平均为 21.2 分。然而,在死亡患者中,评分范围为 23 至 41 分,平均为 32.8 分。因此,通过评估 Kappa 一致性指数的最佳值,确定了 27 分的截断点,并通过 ROC 曲线计算得出:90.90%的敏感性和 78.13%的特异性。

结论

基于这些结果,当指数达到=27 分时,MPI 可以有效地估计死亡风险。将患者分为不同的风险组有助于确定更好的预后并定义手术风险,从而有助于选择手术方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91d7/10578822/d9925c216c9e/rcbc-49-e20222991-g001.jpg

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