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Mannheim Peritonitis Index

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21. Prognostic factors in patients with acute mesenteric ischemia (PubMed)

). Age, gender, accompanying disorders, clinical, laboratory and radiologic findings, duration until laparotomy, evaluation according to the Mannheim Peritonitis Index postoperative complications, surgical treatment applied, and type of ischemia and outcome following surgery were recorded.A total of 46 patients composed of 22 males and 24 females with a mean age of 67.5±17.9 and with a diagnosis of mesenteric ischemia were included in the study. Twenty-seven patients died (58.7%) while 19 survived (...) (41.3%). The mean MPI score was 16.8±4.7 and 25.0±6 in Group 1 and Group 2, respectively, and the difference between the two groups was statistically significant (p<0,001). Fourteen of the 16 (51.9%) patients who had a Mannheim Peritonitis Index score of 26 or higher died while two of them survived (10.5%). Thirteen out of the 30 (48.1%) patients with a Mannheim Peritonitis Index score of 25 or lower died while 17 (89.5%) patients survived. The increased MPI score was significantly correlated

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2017 Turkish Journal of Surgery

24. Perforated Peptic Ulcer Repair: Factors Predicting Conversion in Laparoscopy and Postoperative Septic Complications. (PubMed)

. Laparoscopically operated patients had a shorter hospital stay (13.7 vs. 15.1 days). In an intention-to-treat analysis, patients with conversion to open surgery (analyzed as subgroup from laparoscopic approach group) showed no prolonged hospital stay (15.3 days) compared to patients with a primary open approach. Complication and mortality rates were not different between the groups. The statistical analysis identified four intraoperative risk factors for conversion: Mannheim peritonitis index (MPI) > 21 (p (...)  = 0.02), generalized peritonitis (p = 0.04), adhesions, and perforations located in a region other than the duodenal anterior wall. We found seven predictive factors for septic complications: age >70 (p = 0.02), cardiopulmonary disease (p = 0.04), ASA > 3 (p = 0.002), CRP > 100 (p = 0.005), duration of symptoms >24 h (p = 0.02), MPI > 21(p = 0.008), and generalized peritonitis (p = 0.02).Our data suggest that a primary laparoscopic approach has no disadvantages. Factors necessitating conversions

2016 World Journal of Surgery

25. Liver Cirrhosis/Severe Fibrosis Is a Risk Factor for Anastomotic Leakage after Colorectal Surgery (PubMed)

and rectal anastomoses were identified (n = 1875). A temporary loop ileostomy was constructed in 257 cases (13.7%) either due to Mannheimer Peritonitis-Index > 29 or rectal anastomosis below 6 cm from the anal verge. More than one-third of the patients (n = 691) had postoperative contrast enema, either at the occasion of another study or prior to closure of ileostomy. The presence of liver cirrhosis and the development of anastomotic leakage were assessed by chart review. Results. The overall anastomotic

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2016 Gastroenterology research and practice

26. Ostomy in Nontraumatic Conditions: Our Experience and Review of the Literature (PubMed)

the cases diagnosed as acute abdomen without the history of trauma, which had lead to a procedure requiring colostomy. We retrospectively analysed 105 cases of nontraumatic acute abdomen, resulted in a procedure requiring colostomy. American Society of Anesthesiologists (ASA) scoring and Mannheim Peritonitis Index (MPI) were used in the evaluation of the risk of mortality and morbidity. There were colonic perforations of rectosigmoid tumor in 66 cases (62.8 %), sigmoid volvulus in 10 cases (9.5 (...) Ostomy in Nontraumatic Conditions: Our Experience and Review of the Literature A number of nontraumatic acute abdomen can result in peritonitis leading to sepsis. In emergent conditions, various procedures like segmentary colectomy and/or subtotal colectomy with anastomosis, Hartmann's procedure, transverse colectomy, and/or expandable metallic stent (SEMS) placement can be performed, considering the status of the patient and the facilitaties of the institution. In our study, we examined

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2015 The Indian journal of surgery

27. Laparoscopic repair of perforated peptic ulcer: single-center results. (PubMed)

. A "laparoscopy-first" policy was attempted and then applied for 56 patients. The exclusion criteria for LR ruled out patients who had shock at admission, severe cardiorespiratory comorbidities, or a history of supramesocolic surgery. The aim of this study was a retrospective analysis of the 56 patients treated laparoscopically.The patient distribution was 30 men and 26 women, who had a mean age of 59 years (range 19-95 years). The mean ulcer size was 10 mm, and the Mannheim peritonitis index (MPI) was 21. LR (...) was performed for 39 (69.6%) of the 56 patients and included peritoneal lavage, suturing of the perforation, and omental patching. Conversion to laparotomy was necessary in 17 cases (30.4%). The "conversion group" showed significant differences in ulcer size (larger ulcers: 1.9 vs. 0.7 mm; p < 0.01), ulcer-site topography (higher incidence of posterior ulcers: 5 vs. 0; p < 0.01), and MPI score (higher score: 24 vs. 20; p < 0.05). The LR group had a mean operating time of 86 min (range 50-125 min

2014 Surgical endoscopy

28. Risk factors influencing morbidity and mortality in perforated peptic ulcer disease (PubMed)

patients (18.2%). The most common cause of mortality was sepsis. Multivariate analysis revealed age over 60 years, presence of co-morbidities and Mannheim peritonitis index as independent risk factors for morbidity. Age over 60 years, time to admission and Mannheim peritonitis index were detected as independent risk factors for mortality.Early diagnosis and proper treatment are important in patients presenting with peptic ulcer perforation.

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2014 Turkish Journal of Surgery/Ulusal cerrahi dergisi

29. Megacolon, Toxic (Treatment)

peritonitis index (MPI) class II and American Society of Anesthesiologists (ASA) classes 4-5. [ ] Some physicians provide up to 7 days of medical therapy if the patient demonstrates clinical improvement despite persistent colonic dilatation. The authors recommend a strategy of early surgical intervention to minimize the incidence of colonic perforation. If no improvement occurs over 48-72 hours with medical therapy, perform surgical resection. Whether to perform a total proctocolectomy or a subtotal (...) ), increasing toxicity, and progression of colonic dilatation. Most authors recommend colectomy if persistent dilatation is present or if no improvement is observed on maximal medical therapy after 24-72 hours. The rationale for early intervention is based on a 5-fold increase in mortality after free perforation. The mortality rate for nonperforated, acute toxic colitis is about 4%; if perforation occurs, the mortality is approximately 20%. Significant independent predictors of mortality include Mannheim

2014 eMedicine.com

30. Megacolon, Toxic (Follow-up)

peritonitis index (MPI) class II and American Society of Anesthesiologists (ASA) classes 4-5. [ ] Some physicians provide up to 7 days of medical therapy if the patient demonstrates clinical improvement despite persistent colonic dilatation. The authors recommend a strategy of early surgical intervention to minimize the incidence of colonic perforation. If no improvement occurs over 48-72 hours with medical therapy, perform surgical resection. Whether to perform a total proctocolectomy or a subtotal (...) ), increasing toxicity, and progression of colonic dilatation. Most authors recommend colectomy if persistent dilatation is present or if no improvement is observed on maximal medical therapy after 24-72 hours. The rationale for early intervention is based on a 5-fold increase in mortality after free perforation. The mortality rate for nonperforated, acute toxic colitis is about 4%; if perforation occurs, the mortality is approximately 20%. Significant independent predictors of mortality include Mannheim

2014 eMedicine.com

31. Scoring systems for outcome prediction in patients with perforated peptic ulcer. (PubMed)

, the Hacettepe score, the Jabalpur score the peptic ulcer perforation (PULP) score, the ASA score, the Charlson comorbidity index, the sepsis score, the Mannheim Peritonitis Index (MPI), the Acute physiology and chronic health evaluation II (APACHE II), the simplified acute physiology score II (SAPS II), the Mortality probability models II (MPM II), the Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity physical sub-score (POSSUM-phys score). Only four of the scores

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2013 Scandinavian journal of trauma, resuscitation and emergency medicine

32. Open Abdomen Treatment with Dynamic Sutures and Topical Negative Pressure Resulting in a High Primary Fascia Closure Rate. (PubMed)

-88 years); median Mannheim peritonitis index 25 (5-43) underwent emergent laparotomy for diverse abdominal conditions (abdominal sepsis 78 %, ischemia 16 %, other 6 %).Hospital mortality was 21 % (13 % died during OA treatment); delayed primary fascia closure was 76 % in the intent-to-treat population and 87 % in surviving patients. Six patients required reoperation for abdominal abscess and five patients for anastomotic leakage; enteric fistulas were observed in five (3 %) patients (...) . In a multivariate analysis, factors correlating significantly with high fascia closure rate were limited surgery at the emergency operation and a Björk index of 1 or 2; factors correlating significantly with low fascia closure rate were male sex and generalized peritonitis.With the aid of initially placed dynamic retention sutures, OA treatment with negative pressure results in high rates of delayed primary fascia closure. OA therapy with the technical modifications described is thus considered a suitable

2012 World Journal of Surgery

33. Basilar Artery International Cooperation Study

be feasible within 6 hours of estimated time of BAO. Exclusion criteria Pre-existing dependency with mRankin ≥3. Females of childbearing potential who are known to be pregnant and/or lactating or who have positive pregnancy tests on admission. Patients who require hemodialysis or peritoneal dialysis. Other serious, advanced, or terminal illness. Any other condition that the investigator feels would pose a significant hazard to the patient if thrombolytic therapy is initiated. Current participation (...) Contact: O Pontes Neto Germany Klinikum Augsburg Recruiting Augsburg, Germany Contact: Hauke Schneider Berlin Charite Hospital Recruiting Berlin, Germany Principal Investigator: Heinrich Audebert, MD, PhD Dresden University Hospital Recruiting Dresden, Germany Principal Investigator: Volker Puetz, MD, PhD University Medical Center Mannheim Terminated Mannheim, Germany Oberschwabenklinik Terminated Ravensburg, Germany Italy Bergamo Hospital Recruiting Bergamo, Italy Principal Investigator: Bruno

2012 Clinical Trials

34. ALFApump System Post Marketing Surveillance Registry

Registry, In Support of the Following Indication: Automated Removal of Excess Peritoneal Fluid Into the Urinary Bladder in Patients With Cirrhosis or Malignancy, With Persistent or Refractory Ascites Actual Study Start Date : June 2012 Estimated Primary Completion Date : August 2018 Estimated Study Completion Date : December 2018 Resource links provided by the National Library of Medicine related topics: (AHRQ) related information: Groups and Cohorts Go to Outcome Measures Go to Primary Outcome (...) Leipzig, Germany Medizinische Klinik, Universitätsmedizin Mannheim Mannheim, Germany Uniklinik Würzburg Würzburg, Germany Spain Hosptial Universitari Vall d'Hebron Barcelona, Spain Switzerland Inselspital Bern, Switzerland, 3010 University Clinic of Geneva (HUG) Geneva, Switzerland United Kingdom The London Clinic, The liver centre London, United Kingdom Freeman Hospital Newcastle on Tyne Newcastle on Tyne, United Kingdom Sponsors and Collaborators Sequana Medical AG Investigators Layout table

2012 Clinical Trials

35. Damage Control Surgery with Abdominal Vacuum and Delayed Bowel Reconstruction in Patients with Perforated Diverticulitis Hinchey III/IV. (PubMed)

, with perforated diverticulitis Hinchey III (n = 40, 78%) or Hinchey IV (n = 11, 22%) and a median (range) Mannheim peritonitis index of 26 (12-39), admitted between October 2006 and September 2011, were prospectively enrolled in the study. At initial operation, limited resection of the diseased segment, lavage, and application of abdominal vacuum-assisted closure dressing was performed. After patient resuscitation, a second look was performed in an elective setting.Hospital mortality rate was 9.8%; 35 (76 (...) Damage Control Surgery with Abdominal Vacuum and Delayed Bowel Reconstruction in Patients with Perforated Diverticulitis Hinchey III/IV. With the use of abdominal vacuum therapy, we have developed a damage control concept for patients with perforated diverticulitis and generalized peritonitis. The primary aim of this concept was to enhance recovery and allow bowel reconstruction in a second-look operation.A total of 51 patients (28 female, 55%) with a median (range) age of 69 (28-87) years

2012 Journal of Gastrointestinal Surgery

36. Failure of available scoring systems to predict ongoing infection in patients with abdominal sepsis after their initial emergency laparotomy. (PubMed)

infection. The following scoring systems were evaluated with logistic regression analysis for their ability to select patients requiring a relaparotomy: APACHE-II score, SAPS-II, Mannheim Peritonitis Index (MPI), MODS, SOFA score, and the acute part of the APACHE-II score (APS).The proportion of patients requiring a relaparotomy was 32% (71/221). Only 2 scores had a discriminatory ability in identifying patients with ongoing infection needing relaparotomy above chance: the APS on day 1 (AUC 0.61; 95%CI

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2011 BMC Surgery

37. Role of thoracic epidural block in improving post-operative outcome for septic patients: a preliminary report. (PubMed)

to perforation peritonitis.This randomised non-blinded study included consenting adult patients of the American Society of Anesthesiologists grade II-III, undergoing emergency laparotomy for small intestinal perforation peritonitis. Severity of illness was evaluated using Mannheim Peritonitis Index, Acute Physiology and Chronic Health Evaluation III score and clinical indicators of systemic inflammatory response syndrome. Patients were randomised into two groups depending on the anaesthetic technique

2010 European Journal of Anaesthesiology

38. Predictors of Outcome Following Surgery in Colonic Perforation: An Institution's Experience Over 6 Years. (PubMed)

perforation were excluded. The severity of abdominal sepsis was graded using the Mannheim peritonitis index (MPI).A total of 129 patients, with median age of 65 years (22-97 years), formed the study group. While 29.5% had severe peritoneal contamination, 56.6% had an American Society of Anesthesiologists (ASA) score ≥3. Sigmoid colon (47.3%) and caecum (24.8%) were the most common sites of perforation. Diverticulitis and malignancy were the diagnoses in 51.9% and 34.9%, respectively. Hartmann's procedure (...) >26 and left-sided perforation, and was associated with worse complications.Surgery for colonic perforation is associated with high morbidity and mortality rates. Short-term outcome is determined by ASA score and severity of peritonitis. A lower haematocrit level must alert the possibility of malignancy.

2010 Journal of Gastrointestinal Surgery

39. Right Colonic Perforation in an Asian Population: Predictors of Morbidity and Mortality. (PubMed)

operative intervention for peritonitis from right colonic perforation from July 2003 to April 2008 was performed. Patients were identified from the hospital's diagnostic index and operating records. The severity of abdominal sepsis for all patients was graded using the Mannheim peritonitis index (MPI). All the complications were graded according to the classification proposed by Clavian and colleagues.Fifty-one patients with a median age of 60 years (range, 22-93 years) formed the study group

2009 Journal of Gastrointestinal Surgery

40. Surgery for Small Bowel Perforation in an Asian Population: Predictors of Morbidity and Mortality. (PubMed)

perforation from January 2003 to May 2008 was performed. Patients were identified from the hospital's diagnostic index and operating records. The severity of abdominal sepsis for all patients was graded using the Mannheim peritonitis index (MPI). All the complications were graded according to the classification proposed by Clavien and group.Forty-seven patients, of median age 68 years (18-95 years), formed the study group. Pneumoperitoneum on chest radiographs was seen in only 11 (23.4%) patients. Foreign (...) Surgery for Small Bowel Perforation in an Asian Population: Predictors of Morbidity and Mortality. Peritonitis from small bowel perforation is associated with prohibitive morbidity and mortality rates. The aims of our study were to review our institution's experience in the surgical management of small bowel perforation and to identify factors that could predict morbidity and mortality.A retrospective review of all patients who underwent operative intervention for peritonitis from small bowel

2009 Journal of Gastrointestinal Surgery

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