![]() | Only 14 pages are availabe for public view |
Abstract Before operative therapy was generally used, about 90% of all patients with intraabdominal infection died from sepsis. This outcome might be regarded as the natural course of the disease. The course of the disease is influenced by the physiological reserve of the patients, the acute severity and the type of the disease, the success of the operation and sebsequent management and complications. In the past 10 years, better survival rated have been reported. It is difficuly, however, to attribute the most recent improvement to one specific therapy since several new supportive techniques for the care of patients with serious intraabdominal infection have been recently introduced. These advances include new operative techniques, more potent antimicrobials, new concepts of hemodynamic, respiratory and renal support. Despite advances, mortality from many forms of intra-abdominal infection remains unacceptably high. Therefore, early, objective & reliable classification of the severity of peritonitis is needed. The Acute Physiology And Chronic Health Evaluation score (APACHE II) may be used with pre-operative data for the assessment of the severity of the disease on with postoperative data for monitoring. The Mannheim Peritonitis Indexed (MPI) and the Peritonitis Index Altona II (PIA II) are based on pre-and intra-operative data and are also used for severity assessment. |