Open AccessAssessment of the severity of patients with widespread peritonitis based on the new classification
Author(s) -
A. R. Sarajev
Publication year - 2022
Publication title -
zdravoohranenie tadžikistana
Language(s) - English
Resource type - Journals
ISSN - 0514-2415
DOI - 10.52888/0514-2515-2021-351-4-88-93
Subject(s) - medicine , septic shock , peritonitis , sepsis , incidence (geometry) , shock (circulatory) , apache ii , gastroenterology , sofa score , stage (stratigraphy) , surgery , intensive care unit , paleontology , physics , optics , biology
Aim. To study the efficiency of a new classification of the widespread peritonitis in the estimation of patients’ state severity. Material and methods. 160 patients with widespread peritonitis aged 16 to 76 were examined; 104 (65%) were men and 56 (35%) were women. The patients were divided into 3 groups: 1 - endogenous intoxication (n=95), 2 - abdominal sepsis (n=46), and 3 - septic shock (n=19). The results of treatment were evaluated according to the incidence of postoperative complications, terms of hospitalization, mortality rate. Results and discussion. When analyzing the results of clinical studies, it was found that according to the stages of endogenous intoxication, abdominal sepsis and septic shock, the indicators were as follows: APACHE II 13.8±0.5 - 16.1±0.4 - 18.5±0.5; MIP 22 - 25 - 25; SOFA 3.3±0.2 - 3.7±0.1 - 4.2±0.1; presepsin (pg/mL) 355.6±8.6 - 783.4±24.0 - 1587.7±70.5; tumor necrosis factor-α (pg/mL) 105.5±1.9 - 853.3±17.6 - 24.5±6.8 p/o complications (%) 13.6±3.6 - 35.1±6.1 - 41.9±7.1; hospital stay (days) 19.2±0.8 - 25.9±2.2 - 13.8±1.9; 12 patients died in the stage of septic shock. There were statistically significant differences between the groups (p<0,01). Conclusion. The improved classification stratifies patients with diffuse peritonitis according to severity into the following groups: endogenous intoxication, abdominal sepsis, septic shock. It allows determining in time the necessary volume of intensive therapy and surgical tactics.