Which prognostic scoring systems are used for peritonitis and abdominal sepsis?

Updated: Jul 23, 2019
  • Author: Brian J Daley, MD, MBA, FACS, FCCP, CNSC; Chief Editor: Praveen K Roy, MD, AGAF  more...
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Answer

Several scoring systems (eg, APACHE II, SIRS, multiple organ dysfunction syndrome [MODS], Mannheim peritonitis index) have been developed to assess the clinical prognosis of patients with peritonitis. Most of these scores rely on certain host criteria, systemic signs of sepsis, and complications related to organ failure. Although valuable for comparing patient cohorts and institutions, these scores have limited value in the specific day-to-day clinical decision-making process for any given patient. In general, the mortality rate is less than 5% with an APACHE II of less than 15 and rises to greater than 40% with scores above 15. Rising APACHE II scores on days 3 and 7 are associated with an increase of mortality rates to greater than 90%, whereas falling scores predict mortality rates of less than 20%.


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