A scale for predicting postoperative septic complications at acute peritonitis

Abstract

The results of retrospective analysis of treatment outcome 169 patients with acute surgical pathology of abdominal organs complicated by various forms of peritonitis, 79 of whom developed postoperative complications, are presented. The dependence of occurrence and severity of complications on the nature of the underlying disease, clinical manifestations of peritonitis before surgery, anthropometric data research, laboratory methods, Mannheim peritonitis index parameters, comorbidity class, age were studied, using the analysis of variance. As a result, a scale according to which the prediction of complications is conducted in two stages, was developed. Before the surgery, we estimate the previous risk according to the nature of the underlying disease, clinical manifes-tations of peritonitis, comorbidity class. According to identified changes, the final estimation due to the nature of the underlying disease, Mannheim peritonitis index parameters, comorbidity class, stab neutrophil leukocytes number, use of programmed peritoneal cavity sanations is being made during the operation. These indicators provided a certain number of points. Due to these points, patients were referred to several groups: normal group (less than 18), increased (18-25), medium (26-34) and high (more than 35) the risk of complications. This distinction makes it possible to apply the necessary preventive measures at all stages of treatment, since preoperative preparation.