PERÝTONÝTLÝ HASTALARDA MANNHEIM PERÝTONÝT ÝNDEKSÝNÝN ETKÝNLÝÐÝ

Peritonit ve intra-abdominal sepsisli hastalara uygulanacak tedavi seçeneklerinin belirlenmesi ve tedaviye yanýtýn tahmin edilmesi, her dönemde ilgili hekimlerin baþlýca amaçlarýndan birisi olmuþtur. Ancak bugüne kadar bu amaçlarla önerilen skorlaný sistemleri beklentilere tam anlamýyla yanýt verememiþtir. Son 20 yýlda önerilen skorlama sistemlerinden Mannheim Peritonit Ýndeksi(MPÝ), uygulama kolaylýðý ve etkinliði ile oldukça ön plana çýkmýþtýr. Bu skorlama sisteminin deðerlendirilmesi amacýyla 1995-1999 yýllarý arasýnda Ege ve Dokuz Eylül Üniversitesi Týp Fakültesi Genel Cerrahi Anabilim Dallarýnda deðiþik etiyolojilere baðlý peritonit ve intra-abdominal sepsisli 325 olgu retrospektif olarak hastane kayýtlarýndan incelenmiþtir. Hastalarýn 258'i(%79.4) þifa veya selah ile taburcu edilmiþken, 67'si (%20.6) ise kaybedilmiþtir. Ölen hastalarýn tümünde MPI skoru 26 ve üstündedir. Bu hastalarda ortalama deðer 30.23 7.05 iken, þifa veya selah ile taburcu edilenlerde deðer ortalamasý 18.55 6.67 olmuþtur. Tek tek ele alýndýðýnda, MPI'inde belirleyici olan risk faktörleri ile eksitus olanlar ve olmayanlar bakýmýndan kestirimde bulunma oranlan arasýnda anlamlý farklýlýk saptanmýþtýr. Sonuç olarak MPI'nin, peritonit veya intra-abdominal sepsis durumlarýnda prognozu belirleyici etkin bir skorlama sistemi olduðu kanýsýna varýldý.

EFFECTIVENESS OF MANNHEIM PERITONITIS INDEX IN PATIENTS WITH PERITONITIS

Classificiation of patients regarding to outcome in early periods of peritonitis or intra-abdominal sepsis, has always been a primary goal of intensive care physicians. In order to predict outcome, a wide variety of scoring systems have been proposed. Mannheim Peritonitis Index (MPI) is one of the most effective scoring systems and its predictive value has been shown previously. Three hundred and twenty five patients that were admitted to Emergency Services in both Ege and Dokuz Eylül University Hospital between 1995 and 1999, have been evaluated retrospectively by using patient records. Among them, 258 patients (79.4%) have been discharged in well condition and 67 patients died (20.6%). In the latter, MPI scores were always equal or more than 26. Mean MPI scores were 30,23 7,05 and 18,55 6,67 in exitus group and discharged group respectively. When all descriptive factors in MPI have been evaluated separately, every predictor was revealed statistically significant differences between exitus and discharged groups. It has been concluded that MPI is effective scoring system in terms of predicting final outcome in patients with peritonitis and intraabdominal sepsis.