Proinflammatory citokines and Mannheim index in predicting mortality rates in patients with peritonitis caused by perforation

摘要

Acute diffuse peritonitis caused by perforation represents a complex entity, which, beside thesurgery itself, represents the understanding of the physiopathological mechanisms designed toanticipate the unfavorable evolution. Material and methods: A prospective study was undergone on alot of 100 patients, 71 males and 29 females, who were hospitalized in the General Surgery Clinic of“Bagdasar Arseni” Clinical Emergency Hospital, while being diagnosed with peritonitis caused byperforation, for which the value of proinflammatory cytokines (IL1?, IL6 and TNF?) and also ofMannheim Index was analyzed in predicting the mortality rate. Cytokines dosage was preoperatoryperformed and also on the 3rd and 7th day postoperatory and Mannheim Index was immediatelycalculated postoperatory. Results: The results for IL1-? were insignificant and had no statistical value.However, from the serial determination in the dynamics of the other proinflammatory cytokines, IL6and TNF?, it resulted that these could be important in the quantification of the mortality rate risk.Moreover, the Mannheim Index was calculated, thus achieving a higher score or equal to 26 points, asensitivity of 0.7895 and a specificity of 0.7284 in the prediction of the mortality rate. Conclusions:Both IL6 and TNF? have an important value in predicting the mortality rates in patients with acutediffuse peritonitis caused by digestive tract perforations, the patients with elevated serumconcentrations both at admission in hospital and postoperatory evolving more frequently to death. Thecalculation of Mannheim Index is useful in patients with peritonitis caused by perforation, the patientswith a higher score or equal to 26 points having a higher mortality rate risk.