Ohmann C, Wittmann D H, Wacha H
Department of General and Trauma Surgery, Heinrich-Heine-University, Düsseldorf, Germany.
Eur J Surg. 1993 May;159(5):267-74.
To assess the accuracy of the APACHE II score, the Mannheim Peritonitis Index (MPI), and the Peritonitis Index Altona (PIA) II in the prediction of outcome of patients with peritonitis.
Prospective, multicentre study.
12 Departments of Surgery in Europe.
271 Patients with peritonitis confirmed at laparatomy.
Computation of the three scores on one set of data for each patient.
The ability to predict death or survival within 30 days of operation with each of the three scores. The prediction were evaluated according to the following criteria: discriminatory ability (areas under the receiver-operator characteristic (ROC) curves relating sensitivity to specificity); sharpness (level of confidence that was associated with a prediction); and reliability (agreement between predicted and observed mortality within equidistant intervals on the scale).
APACHE II was superior to both the MPI and PIA II in its discriminatory ability and reliability, but the MPI and PIA II made more "sharp" predictions.
None of the three scores is of any use for predicting the outcome for individual patients. APACHE II is the current standard for assessing the severity of peritonitis.
评估急性生理与慢性健康状况评分系统（APACHE II）、曼海姆腹膜炎指数（MPI）和阿尔托纳腹膜炎指数（PIA）II在预测腹膜炎患者预后方面的准确性。
前瞻性多中心研究。
欧洲12个外科科室。
271例经剖腹手术确诊为腹膜炎的患者。
为每位患者的一组数据计算三个评分。
用三个评分中的每一个来预测患者术后30天内的死亡或存活情况。根据以下标准评估预测结果：区分能力（将敏感度与特异度相关的受试者工作特征曲线下面积）；清晰度（与预测相关的置信水平）；以及可靠性（在量表上等距区间内预测死亡率与观察到的死亡率之间的一致性）。
APACHE II在区分能力和可靠性方面优于MPI和PIA II，但MPI和PIA II做出的“清晰”预测更多。
这三个评分均无助于预测个体患者的预后。APACHE II是目前评估腹膜炎严重程度的标准。
