Patient selection: secondary peritonitis following initial surgical management
Parameters:
(1) contamination
(2) defecation
(3) inotropic medications
(4) body temperature in °C
(5) heart rate in beats per minute
(6) hemoglobin in mmol/L (the conversion factor from g/dL to mmol/L appears to be 0.6206).
|
Parameter
|
Finding
|
Points
|
Beta-Coefficient
|
|
contamination
|
local
|
0
|
0
|
|
|
diffuse
|
7
|
0.76695
|
|
defecation
|
no
|
14
|
1.46956
|
|
|
yes
|
0
|
0
|
|
inotropic meds
|
no
|
0
|
0
|
|
|
yes
|
14
|
1.40856
|
|
body temperature
|
< 35.5°C
|
9
|
0.91645
|
|
|
35.5 to 39°C
|
0
|
0
|
|
|
> 39°C
|
9
|
0.91645
|
|
heart rate
|
<= 90 bpm
|
0
|
0
|
|
|
> 90 bpm
|
6
|
0.67818
|
|
hemoglobin
|
<= 5 mmol/L (8.1 g/dL)
|
10
|
1.09552
|
|
|
> 5 mmol/L
|
0
|
0
|
total score =
= SUM(points for all 6 parameters)
X =
= SUM(beta coefficients) - 4.412803 (original)
= SUM(beta coefficients) - 3.135282 (updated)
probability of persistent sepsis =
= 1 / (1 + EXP((-1) * X))
Interpretation:
• minimum score: 0
• maximum score: 60
• The higher the score the greater the risk of ongoing peritonitis.
|
Total Score
|
Risk Group
|
Abdominal Sepsis
|
|
0 to 20
|
low
|
11%
|
|
21 to 40
|
intermediate
|
35%
|
|
> 40
|
high
|
67%
|
|
Risk Group
|
Perform CT
|
Repeat Decision Rule
|
|
low
|
no
|
24 hours
|
|
intermediate
|
consider
|
12 hours
|
|
high
|
yes
|
12 hours if CT negative
|
Performance:
• The area under the ROC curve is 0.80.
