Department of Surgery, Mansoura University, Mansoura, Egypt.
Medicine (Baltimore). 2024 Mar 1;103(9):e37377. doi: 10.1097/MD.0000000000037377.
Anorectal sepsis is a common and potentially serious medical condition characterized by infection and inflammation of the anal canal and surrounding tissues. However, the lack of standardized and comprehensive scoring systems specifically tailored for predicting the severity of anorectal sepsis poses challenges in clinical practice. This study aimed to develop and validate a scoring system for predicting the severity of anorectal sepsis by incorporating relevant patient factors. A retrospective cohort study was conducted at Mansoura University Hospital, a tertiary care center, over a period of 5 years. The study population consisted of 330 patients diagnosed with anorectal sepsis during the study period. A scoring system was developed using multiple variables, with each variable assigned a specific score based on its clinical significance and weight in predicting disease severity. The developed scoring system's predictive performance was evaluated using receiver operating characteristic (ROC) analysis, calculating the area under the ROC curve to assess discriminative ability. Descriptive statistics were used to summarize the demographic and clinical characteristics of the study population. Chi-square tests or t tests were performed to assess differences between non-severe and severe anal sepsis groups. The scoring system consisted of 12 variables, with a maximum total score of 18. The logistic regression analysis revealed significant associations between localized swelling, presentation within 72 hours, multiple drainage sessions, and severe anorectal sepsis. The ROC analysis showed an area under the curve of 0.85, indicating good discriminative ability of the scoring system. The scoring system was developed and validated in a single center, which may limit its generalizability to other settings. The scoring system demonstrated good predictive performance and can be a valuable tool for clinicians in assessing disease severity, guiding treatment decisions, and identifying high-risk patients.
肛门直肠周围脓肿是一种常见且潜在严重的医学病症，其特征为肛门直肠和周围组织的感染和炎症。然而，缺乏专门针对预测肛门直肠周围脓肿严重程度的标准化和全面评分系统，给临床实践带来了挑战。本研究旨在通过纳入相关患者因素，开发和验证一种用于预测肛门直肠周围脓肿严重程度的评分系统。一项回顾性队列研究在曼苏拉大学医院进行，该医院是一家三级保健中心，研究时间为 5 年。研究人群由 330 名在研究期间被诊断为肛门直肠周围脓肿的患者组成。使用多个变量开发了评分系统，根据每个变量在预测疾病严重程度方面的临床意义和权重，为其分配特定的分数。使用接受者操作特征（ROC）分析评估所开发评分系统的预测性能，计算 ROC 曲线下的面积以评估区分能力。使用描述性统计数据总结研究人群的人口统计学和临床特征。进行卡方检验或 t 检验，以评估非严重和严重肛门直肠周围脓肿组之间的差异。评分系统由 12 个变量组成，总分最高为 18 分。逻辑回归分析显示，局部肿胀、72 小时内出现症状、多次引流治疗和严重肛门直肠周围脓肿之间存在显著关联。ROC 分析显示曲线下面积为 0.85，表明评分系统具有良好的区分能力。该评分系统在单中心开发和验证，可能限制了其在其他环境中的通用性。该评分系统表现出良好的预测性能，可作为临床医生评估疾病严重程度、指导治疗决策和识别高风险患者的有用工具。
