Billing A, Fröhlich D, Schildberg F W
Chirurgische Klinik, Klinikum Grosshadern, Ludwig-Maximilians-Universität München, Germany.
Br J Surg. 1994 Feb;81(2):209-13. doi: 10.1002/bjs.1800810217.
Early prognostic evaluation of abdominal sepsis is desirable to select high-risk patients for more aggressive therapeutic procedures and to provide objective classification of the severity of disease. The reliability of the Mannheim peritonitis index was assessed and its predictive power for different populations examined in a study of 2003 patients from seven centres in three European countries. The prevalence of risk factors varied considerably between the groups. For a threshold index score of 26, the sensitivity was 86 (range 54-98) per cent, specificity 74 (range 58-97) per cent and accuracy 83 (range 70-94) per cent in predicting death. For patients with a score less than 21 the mean mortality rate was 2.3 (range 0-11) per cent, for score 21-29 22.5 (range 10.6-50) per cent and for score greater than 29 59.1 (range 41-87) per cent. The mean index score and mean mortality rate correlated in the different groups, reflecting a homogeneous standard of therapy for peritonitis. The Mannheim peritonitis index provides an easy and reliable means of risk evaluation and classification for patients with peritoneal inflammation.
对腹部脓毒症进行早期预后评估，有助于筛选出高危患者，以便采取更积极的治疗措施，并对疾病的严重程度进行客观分类。在一项对来自三个欧洲国家七个中心的2003例患者的研究中，评估了曼海姆腹膜炎指数的可靠性，并检验了其对不同人群的预测能力。各组间危险因素的患病率差异很大。对于阈值指数评分为26的情况，预测死亡时的敏感性为86（范围54 - 98）%，特异性为74（范围58 - 97）%，准确性为83（范围70 - 94）%。对于评分低于21的患者，平均死亡率为2.3（范围0 - 11）%；评分21 - 29的患者，平均死亡率为22.5（范围10.6 - 50）%；评分高于29的患者，平均死亡率为59.1（范围41 - 87）%。不同组的平均指数评分与平均死亡率相关，反映了腹膜炎治疗的同质化标准。曼海姆腹膜炎指数为有腹膜炎症的患者提供了一种简单可靠的风险评估和分类方法。
