Abstract
Background: Timing and adequacy of peritoneal source control are the most important pillars in the management of patients with acute peritonitis. Therefore, early prognostic evaluation of acute peritonitis is paramount to assess the severity and establish a prompt and appropriate treatment. The objectives of this study were to identify clinical and laboratory predictors for in-hospital mortality in patients with acute peritonitis and to develop a warning score system, based on easily recognizable and assessable variables, globally accepted. Methods: This worldwide multicentre observational study included 153 surgical departments across 56 countries over a 4-month study period between February 1, 2018, and May 31, 2018. Results: A total of 3137 patients were included, with 1815 (57.9%) men and 1322 (42.1%) women, with a median age of 47 years (interquartile range [IQR] 28-66). The overall in-hospital mortality rate was 8.9%, with a median length of stay of 6 days (IQR 4-10). Using multivariable logistic regression, independent variables associated with in-hospital mortality were identified: age > 80 years, malignancy, severe cardiovascular disease, severe chronic kidney disease, respiratory rate ≥ 22 breaths/min, systolic blood pressure < 100 mmHg, AVPU responsiveness scale (voice and unresponsive), blood oxygen saturation level (SpO2) < 90% in air, platelet count < 50,000 cells/mm3, and lactate > 4 mmol/l. These variables were used to create the PIPAS Severity Score, a bedside early warning score for patients with acute peritonitis. The overall mortality was 2.9% for patients who had scores of 0-1, 22.7% for those who had scores of 2-3, 46.8% for those who had scores of 4-5, and 86.7% for those who have scores of 7-8. Conclusions: The simple PIPAS Severity Score can be used on a global level and can help clinicians to identify patients at high risk for treatment failure and mortality.
| Original language | English |
|---|---|
| Article number | 34 |
| Journal | World Journal of Emergency Surgery |
| Volume | 14 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jul 15 2019 |
Keywords
- Acute peritonitis
- Early warning score
- Emergency surgery
- Source control
- Abdomen/abnormalities
- Prognosis
- Hospital Mortality
- Humans
- Middle Aged
- Risk Factors
- Logistic Models
- Male
- Chi-Square Distribution
- Sepsis/diagnosis
- Injury Severity Score
- Adult
- Female
- Aged
ASJC Scopus subject areas
- Surgery
- Emergency Medicine
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Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study : A WSES observational study. / Sartelli, Massimo; Abu-Zidan, Fikri M.; Labricciosa, Francesco M.; Kluger, Yoram; Coccolini, Federico; Ansaloni, Luca; Leppäniemi, Ari; Kirkpatrick, Andrew W.; Tolonen, Matti; Tranà, Cristian; Regimbeau, Jean Marc; Hardcastle, Timothy; Koshy, Renol M.; Abbas, Ashraf; Aday, Ulaş; Adesunkanmi, A. R.K.; Ajibade, Adesina; Akhmeteli, Lali; Akln, Emrah; Akkapulu, Nezih; Alotaibi, Alhenouf; Altintoprak, Fatih; Anyfantakis, Dimitrios; Atanasov, Boyko; Augustin, Goran; Azevedo, Constança; Bala, Miklosh; Balalis, Dimitrios; Baraket, Oussama; Baral, Suman; Barkai, Or; Beltran, Marcelo; Bini, Roberto; Bouliaris, Konstantinos; Caballero, Ana B.; Calu, Valentin; Catani, Marco; Ceresoli, Marco; Charalampakis, Vasileios; Jusoh, Asri Che; Chiarugi, Massimo; Cillara, Nicola; Cuesta, Raquel Cobos; Cobuccio, Luigi; Cocorullo, Gianfranco; Colak, Elif; Conti, Luigi; Cui, Yunfeng; De Simone, Belinda; Delibegovic, Samir; Demetrashvili, Zaza; Demetriades, Demetrios; Dimova, Ana; Dogjani, Agron; Enani, Mushira; Farina, Federica; Ferrara, Francesco; Foghetti, Domitilla; Fontana, Tommaso; Fraga, Gustavo P.; Gachabayov, Mahir; Gérard, Grelpois; Ghnnam, Wagih; Maurel, Teresa Giménez; Gkiokas, Georgios; Gomes, Carlos A.; Guner, Ali; Gupta, Sanjay; Hecker, Andreas; Hirano, Elcio S.; Hodonou, Adrien; Hutan, Martin; Ilaschuk, Igor; Ioannidis, Orestis; Isik, Arda; Ivakhov, Georgy; Jain, Sumita; Jokubauskas, Mantas; Karamarkovic, Aleksandar; Kaushik, Robin; Kenig, Jakub; Khokha, Vladimir; Khokha, Denis; Kim, Jae Il; Kong, Victor; Korkolis, Dimitris; Kruger, Vitor F.; Kshirsagar, Ashok; Simões, Romeo Lages; Lanaia, Andrea; Lasithiotakis, Konstantinos; Leão, Pedro; Arellano, Miguel León; Listle, Holger; Litvin, Andrey; Lizarazu Pérez, Aintzane; Lopez-Tomassetti Fernandez, Eudaldo; Lostoridis, Eftychios; Luppi, Davide; Machain V, Gustavo M.; Major, Piotr; Manatakis, Dimitrios; Reitz, Marianne Marchini; Marinis, Athanasios; Marrelli, Daniele; Martínez-Pérez, Aleix; Marwah, Sanjay; McFarlane, Michael; Mesic, Mirza; Mesina, Cristian; Michalopoulos, Nickos; Misiakos, Evangelos; Moreira, Felipe Gonçalves; Mouaqit, Ouadii; Muhtaroglu, Ali; Naidoo, Noel; Negoi, Ionut; Nikitina, Zane; Nikolopoulos, Ioannis; Nita, Gabriela Elisa; Occhionorelli, Savino; Olaoye, Iyiade; Ordoñez, Carlos A.; Ozkan, Zeynep; Pal, Ajay; Palini, Gian M.; Papageorgiou, Kyriaki; Papagoras, Dimitris; Pata, Francesco; Pȩdziwiatr, Michał; Pereira, Jorge; Pereira Junior, Gerson A.; Perrone, Gennaro; Pintar, Tadeja; Pisarska, Magdalena; Plehutsa, Oleksandr; Podda, Mauro; Poillucci, Gaetano; Quiodettis, Martha; Rahim, Tuba; Rios-Cruz, Daniel; Rodrigues, Gabriel; Rozov, Dmytry; Sakakushev, Boris; Sall, Ibrahima; Sazhin, Alexander; Semião, Miguel; Sharda, Taanya; Shelat, Vishal; Sinibaldi, Giovanni; Skicko, Dmitrijs; Skrovina, Matej; Stamatiou, Dimitrios; Stella, Marco; Strzałka, Marcin; Sydorchuk, Ruslan; Teixeira Gonsaga, Ricardo A.; Tochie, Joel Noutakdie; Tomadze, Gia; Ugoletti, Lara; Ulrych, Jan; Ümarik, Toomas; Uzunoglu, Mustafa Y.; Vasilescu, Alin; Vaz, Osborne; Vereczkei, Andras; Vlad, Nutu; Walȩdziak, Maciej; Yahya, Ali I.; Yalkin, Omer; Yilmaz, Tonguç U.; Ünal, Ali Ekrem; Yuan, Kuo Ching; Zachariah, Sanoop K.; Žilinskas, Justas; Zizzo, Maurizio; Pattonieri, Vittoria; Baiocchi, Gian Luca; Catena, Fausto.
In: World Journal of Emergency Surgery, Vol. 14, No. 1, 34, 15.07.2019.Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study
T2 - A WSES observational study
AU - Sartelli, Massimo
AU - Abu-Zidan, Fikri M.
AU - Labricciosa, Francesco M.
AU - Kluger, Yoram
AU - Coccolini, Federico
AU - Ansaloni, Luca
AU - Leppäniemi, Ari
AU - Kirkpatrick, Andrew W.
AU - Tolonen, Matti
AU - Tranà, Cristian
AU - Regimbeau, Jean Marc
AU - Hardcastle, Timothy
AU - Koshy, Renol M.
AU - Abbas, Ashraf
AU - Aday, Ulaş
AU - Adesunkanmi, A. R.K.
AU - Ajibade, Adesina
AU - Akhmeteli, Lali
AU - Akln, Emrah
AU - Akkapulu, Nezih
AU - Alotaibi, Alhenouf
AU - Altintoprak, Fatih
AU - Anyfantakis, Dimitrios
AU - Atanasov, Boyko
AU - Augustin, Goran
AU - Azevedo, Constança
AU - Bala, Miklosh
AU - Balalis, Dimitrios
AU - Baraket, Oussama
AU - Baral, Suman
AU - Barkai, Or
AU - Beltran, Marcelo
AU - Bini, Roberto
AU - Bouliaris, Konstantinos
AU - Caballero, Ana B.
AU - Calu, Valentin
AU - Catani, Marco
AU - Ceresoli, Marco
AU - Charalampakis, Vasileios
AU - Jusoh, Asri Che
AU - Chiarugi, Massimo
AU - Cillara, Nicola
AU - Cuesta, Raquel Cobos
AU - Cobuccio, Luigi
AU - Cocorullo, Gianfranco
AU - Colak, Elif
AU - Conti, Luigi
AU - Cui, Yunfeng
AU - De Simone, Belinda
AU - Delibegovic, Samir
AU - Demetrashvili, Zaza
AU - Demetriades, Demetrios
AU - Dimova, Ana
AU - Dogjani, Agron
AU - Enani, Mushira
AU - Farina, Federica
AU - Ferrara, Francesco
AU - Foghetti, Domitilla
AU - Fontana, Tommaso
AU - Fraga, Gustavo P.
AU - Gachabayov, Mahir
AU - Gérard, Grelpois
AU - Ghnnam, Wagih
AU - Maurel, Teresa Giménez
AU - Gkiokas, Georgios
AU - Gomes, Carlos A.
AU - Guner, Ali
AU - Gupta, Sanjay
AU - Hecker, Andreas
AU - Hirano, Elcio S.
AU - Hodonou, Adrien
AU - Hutan, Martin
AU - Ilaschuk, Igor
AU - Ioannidis, Orestis
AU - Isik, Arda
AU - Ivakhov, Georgy
AU - Jain, Sumita
AU - Jokubauskas, Mantas
AU - Karamarkovic, Aleksandar
AU - Kaushik, Robin
AU - Kenig, Jakub
AU - Khokha, Vladimir
AU - Khokha, Denis
AU - Kim, Jae Il
AU - Kong, Victor
AU - Korkolis, Dimitris
AU - Kruger, Vitor F.
AU - Kshirsagar, Ashok
AU - Simões, Romeo Lages
AU - Lanaia, Andrea
AU - Lasithiotakis, Konstantinos
AU - Leão, Pedro
AU - Arellano, Miguel León
AU - Listle, Holger
AU - Litvin, Andrey
AU - Lizarazu Pérez, Aintzane
AU - Lopez-Tomassetti Fernandez, Eudaldo
AU - Lostoridis, Eftychios
AU - Luppi, Davide
AU - Machain V, Gustavo M.
AU - Major, Piotr
AU - Manatakis, Dimitrios
AU - Reitz, Marianne Marchini
AU - Marinis, Athanasios
AU - Marrelli, Daniele
AU - Martínez-Pérez, Aleix
AU - Marwah, Sanjay
AU - McFarlane, Michael
AU - Mesic, Mirza
AU - Mesina, Cristian
AU - Michalopoulos, Nickos
AU - Misiakos, Evangelos
AU - Moreira, Felipe Gonçalves
AU - Mouaqit, Ouadii
AU - Muhtaroglu, Ali
AU - Naidoo, Noel
AU - Negoi, Ionut
AU - Nikitina, Zane
AU - Nikolopoulos, Ioannis
AU - Nita, Gabriela Elisa
AU - Occhionorelli, Savino
AU - Olaoye, Iyiade
AU - Ordoñez, Carlos A.
AU - Ozkan, Zeynep
AU - Pal, Ajay
AU - Palini, Gian M.
AU - Papageorgiou, Kyriaki
AU - Papagoras, Dimitris
AU - Pata, Francesco
AU - Pȩdziwiatr, Michał
AU - Pereira, Jorge
AU - Pereira Junior, Gerson A.
AU - Perrone, Gennaro
AU - Pintar, Tadeja
AU - Pisarska, Magdalena
AU - Plehutsa, Oleksandr
AU - Podda, Mauro
AU - Poillucci, Gaetano
AU - Quiodettis, Martha
AU - Rahim, Tuba
AU - Rios-Cruz, Daniel
AU - Rodrigues, Gabriel
AU - Rozov, Dmytry
AU - Sakakushev, Boris
AU - Sall, Ibrahima
AU - Sazhin, Alexander
AU - Semião, Miguel
AU - Sharda, Taanya
AU - Shelat, Vishal
AU - Sinibaldi, Giovanni
AU - Skicko, Dmitrijs
AU - Skrovina, Matej
AU - Stamatiou, Dimitrios
AU - Stella, Marco
AU - Strzałka, Marcin
AU - Sydorchuk, Ruslan
AU - Teixeira Gonsaga, Ricardo A.
AU - Tochie, Joel Noutakdie
AU - Tomadze, Gia
AU - Ugoletti, Lara
AU - Ulrych, Jan
AU - Ümarik, Toomas
AU - Uzunoglu, Mustafa Y.
AU - Vasilescu, Alin
AU - Vaz, Osborne
AU - Vereczkei, Andras
AU - Vlad, Nutu
AU - Walȩdziak, Maciej
AU - Yahya, Ali I.
AU - Yalkin, Omer
AU - Yilmaz, Tonguç U.
AU - Ünal, Ali Ekrem
AU - Yuan, Kuo Ching
AU - Zachariah, Sanoop K.
AU - Žilinskas, Justas
AU - Zizzo, Maurizio
AU - Pattonieri, Vittoria
AU - Baiocchi, Gian Luca
AU - Catena, Fausto
N1 - Publisher Copyright: © 2019 The Author(s). Copyright: Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/7/15
Y1 - 2019/7/15
N2 - Background: Timing and adequacy of peritoneal source control are the most important pillars in the management of patients with acute peritonitis. Therefore, early prognostic evaluation of acute peritonitis is paramount to assess the severity and establish a prompt and appropriate treatment. The objectives of this study were to identify clinical and laboratory predictors for in-hospital mortality in patients with acute peritonitis and to develop a warning score system, based on easily recognizable and assessable variables, globally accepted. Methods: This worldwide multicentre observational study included 153 surgical departments across 56 countries over a 4-month study period between February 1, 2018, and May 31, 2018. Results: A total of 3137 patients were included, with 1815 (57.9%) men and 1322 (42.1%) women, with a median age of 47 years (interquartile range [IQR] 28-66). The overall in-hospital mortality rate was 8.9%, with a median length of stay of 6 days (IQR 4-10). Using multivariable logistic regression, independent variables associated with in-hospital mortality were identified: age > 80 years, malignancy, severe cardiovascular disease, severe chronic kidney disease, respiratory rate ≥ 22 breaths/min, systolic blood pressure < 100 mmHg, AVPU responsiveness scale (voice and unresponsive), blood oxygen saturation level (SpO2) < 90% in air, platelet count < 50,000 cells/mm3, and lactate > 4 mmol/l. These variables were used to create the PIPAS Severity Score, a bedside early warning score for patients with acute peritonitis. The overall mortality was 2.9% for patients who had scores of 0-1, 22.7% for those who had scores of 2-3, 46.8% for those who had scores of 4-5, and 86.7% for those who have scores of 7-8. Conclusions: The simple PIPAS Severity Score can be used on a global level and can help clinicians to identify patients at high risk for treatment failure and mortality.
AB - Background: Timing and adequacy of peritoneal source control are the most important pillars in the management of patients with acute peritonitis. Therefore, early prognostic evaluation of acute peritonitis is paramount to assess the severity and establish a prompt and appropriate treatment. The objectives of this study were to identify clinical and laboratory predictors for in-hospital mortality in patients with acute peritonitis and to develop a warning score system, based on easily recognizable and assessable variables, globally accepted. Methods: This worldwide multicentre observational study included 153 surgical departments across 56 countries over a 4-month study period between February 1, 2018, and May 31, 2018. Results: A total of 3137 patients were included, with 1815 (57.9%) men and 1322 (42.1%) women, with a median age of 47 years (interquartile range [IQR] 28-66). The overall in-hospital mortality rate was 8.9%, with a median length of stay of 6 days (IQR 4-10). Using multivariable logistic regression, independent variables associated with in-hospital mortality were identified: age > 80 years, malignancy, severe cardiovascular disease, severe chronic kidney disease, respiratory rate ≥ 22 breaths/min, systolic blood pressure < 100 mmHg, AVPU responsiveness scale (voice and unresponsive), blood oxygen saturation level (SpO2) < 90% in air, platelet count < 50,000 cells/mm3, and lactate > 4 mmol/l. These variables were used to create the PIPAS Severity Score, a bedside early warning score for patients with acute peritonitis. The overall mortality was 2.9% for patients who had scores of 0-1, 22.7% for those who had scores of 2-3, 46.8% for those who had scores of 4-5, and 86.7% for those who have scores of 7-8. Conclusions: The simple PIPAS Severity Score can be used on a global level and can help clinicians to identify patients at high risk for treatment failure and mortality.
KW - Acute peritonitis
KW - Early warning score
KW - Emergency surgery
KW - Source control
KW - Abdomen/abnormalities
KW - Prognosis
KW - Hospital Mortality
KW - Humans
KW - Middle Aged
KW - Risk Factors
KW - Logistic Models
KW - Male
KW - Chi-Square Distribution
KW - Sepsis/diagnosis
KW - Injury Severity Score
KW - Adult
KW - Female
KW - Aged
UR - http://www.scopus.com/inward/record.url?scp=85069147924&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85069147924&partnerID=8YFLogxK
U2 - 10.1186/s13017-019-0253-2
DO - 10.1186/s13017-019-0253-2
M3 - Article
C2 - 31341511
AN - SCOPUS:85069147924
VL - 14
JO - World Journal of Emergency Surgery
JF - World Journal of Emergency Surgery
SN - 1749-7922
IS - 1
M1 - 34
ER -