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Published in: World Journal of Emergency Surgery 1/2015

Open Access 01-12-2015 | Research article

Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections: a prospective multicentre study (WISS Study)

Authors: Massimo Sartelli, Fikri M. Abu-Zidan, Fausto Catena, Ewen A. Griffiths, Salomone Di Saverio, Raul Coimbra, Carlos A. Ordoñez, Ari Leppaniemi, Gustavo P. Fraga, Federico Coccolini, Ferdinando Agresta, Asrhaf Abbas, Saleh Abdel Kader, John Agboola, Adamu Amhed, Adesina Ajibade, Seckin Akkucuk, Bandar Alharthi, Dimitrios Anyfantakis, Goran Augustin, Gianluca Baiocchi, Miklosh Bala, Oussama Baraket, Savas Bayrak, Giovanni Bellanova, Marcelo A. Beltràn, Roberto Bini, Matthew Boal, Andrey V. Borodach, Konstantinos Bouliaris, Frederic Branger, Daniele Brunelli, Marco Catani, Asri Che Jusoh, Alain Chichom-Mefire, Gianfranco Cocorullo, Elif Colak, David Costa, Silvia Costa, Yunfeng Cui, Geanina Loredana Curca, Terry Curry, Koray Das, Samir Delibegovic, Zaza Demetrashvili, Isidoro Di Carlo, Nadezda Drozdova, Tamer El Zalabany, Mushira Abdulaziz Enani, Mario Faro, Mahir Gachabayov, Teresa Giménez Maurel, Georgios Gkiokas, Carlos Augusto Gomes, Ricardo Alessandro Teixeira Gonsaga, Gianluca Guercioni, Ali Guner, Sanjay Gupta, Sandra Gutierrez, Martin Hutan, Orestis Ioannidis, Arda Isik, Yoshimitsu Izawa, Sumita A. Jain, Mantas Jokubauskas, Aleksandar Karamarkovic, Saila Kauhanen, Robin Kaushik, Jakub Kenig, Vladimir Khokha, Jae Il Kim, Victor Kong, Renol Koshy, Avidyl Krasniqi, Ashok Kshirsagar, Zygimantas Kuliesius, Konstantinos Lasithiotakis, Pedro Leão, Jae Gil Lee, Miguel Leon, Aintzane Lizarazu Pérez, Varut Lohsiriwat, Eudaldo López-Tomassetti Fernandez, Eftychios Lostoridis, Raghuveer Mn, Piotr Major, Athanasios Marinis, Daniele Marrelli, Aleix Martinez-Perez, Sanjay Marwah, Michael McFarlane, Renato Bessa Melo, Cristian Mesina, Nick Michalopoulos, Radu Moldovanu, Ouadii Mouaqit, Akutu Munyika, Ionut Negoi, Ioannis Nikolopoulos, Gabriela Elisa Nita, Iyiade Olaoye, Abdelkarim Omari, Paola Rodríguez Ossa, Zeynep Ozkan, Ramakrishnapillai Padmakumar, Francesco Pata, Gerson Alves Pereira Junior, Jorge Pereira, Tadeja Pintar, Konstantinos Pouggouras, Vinod Prabhu, Stefano Rausei, Miran Rems, Daniel Rios-Cruz, Boris Sakakushev, Maria Luisa Sánchez de Molina, Charampolos Seretis, Vishal Shelat, Romeo Lages Simões, Giovanni Sinibaldi, Matej Skrovina, Dmitry Smirnov, Charalampos Spyropoulos, Jaan Tepp, Tugan Tezcaner, Matti Tolonen, Myftar Torba, Jan Ulrych, Mustafa Yener Uzunoglu, David van Dellen, Gabrielle H. van Ramshorst, Giorgio Vasquez, Aurélien Venara, Andras Vereczkei, Nereo Vettoretto, Nutu Vlad, Sanjay Kumar Yadav, Tonguç Utku Yilmaz, Kuo-Ching Yuan, Sanoop Koshy Zachariah, Maurice Zida, Justas Zilinskas, Luca Ansaloni

Published in: World Journal of Emergency Surgery | Issue 1/2015

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Abstract

Background

To validate a new practical Sepsis Severity Score for patients with complicated intra-abdominal infections (cIAIs) including the clinical conditions at the admission (severe sepsis/septic shock), the origin of the cIAIs, the delay in source control, the setting of acquisition and any risk factors such as age and immunosuppression.

Methods

The WISS study (WSES cIAIs Score Study) is a multicenter observational study underwent in 132 medical institutions worldwide during a four-month study period (October 2014-February 2015). Four thousand five hundred thirty-three patients with a mean age of 51.2 years (range 18–99) were enrolled in the WISS study.

Results

Univariate analysis has shown that all factors that were previously included in the WSES Sepsis Severity Score were highly statistically significant between those who died and those who survived (p < 0.0001). The multivariate logistic regression model was highly significant (p < 0.0001, R2 = 0.54) and showed that all these factors were independent in predicting mortality of sepsis. Receiver Operator Curve has shown that the WSES Severity Sepsis Score had an excellent prediction for mortality. A score above 5.5 was the best predictor of mortality having a sensitivity of 89.2 %, a specificity of 83.5 % and a positive likelihood ratio of 5.4.

Conclusions

WSES Sepsis Severity Score for patients with complicated Intra-abdominal infections can be used on global level. It has shown high sensitivity, specificity, and likelihood ratio that may help us in making clinical decisions.
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Literature
1.
go back to reference Sartelli M, Viale P, Catena F, Ansaloni L, Moore E, Malangoni M, et al. 2013 WSES guidelines for management of intra-abdominal infections. World J Emerg Surg. 2013;8(1):3.PubMedCentralCrossRefPubMed Sartelli M, Viale P, Catena F, Ansaloni L, Moore E, Malangoni M, et al. 2013 WSES guidelines for management of intra-abdominal infections. World J Emerg Surg. 2013;8(1):3.PubMedCentralCrossRefPubMed
2.
go back to reference Mulari K, Leppäniemi A. Severe secondary peritonitis following gastrointestinal tract perforation. Scand J Surg. 2004;93(3):204–8.PubMed Mulari K, Leppäniemi A. Severe secondary peritonitis following gastrointestinal tract perforation. Scand J Surg. 2004;93(3):204–8.PubMed
3.
go back to reference Horiuchi A, Watanabe Y, Doi T, Sato K, Yukumi S, Yoshida M, et al. Evaluation of prognostic factors and scoring system in colonic perforation. World J Gastroenterol. 2007;13(23):3228–31.PubMedCentralCrossRefPubMed Horiuchi A, Watanabe Y, Doi T, Sato K, Yukumi S, Yoshida M, et al. Evaluation of prognostic factors and scoring system in colonic perforation. World J Gastroenterol. 2007;13(23):3228–31.PubMedCentralCrossRefPubMed
4.
go back to reference Evans HL, Raymond DP, Pelletier SJ, Crabtree TD, Pruett TL, Sawyer KG. Tertiary peritonitis (recurrent diffuse or localized disease) is not an independent predictor of mortality in surgical patients with intra-abdominal infection. Surg Infect. 2001;2:255–65.CrossRef Evans HL, Raymond DP, Pelletier SJ, Crabtree TD, Pruett TL, Sawyer KG. Tertiary peritonitis (recurrent diffuse or localized disease) is not an independent predictor of mortality in surgical patients with intra-abdominal infection. Surg Infect. 2001;2:255–65.CrossRef
5.
go back to reference McLauchlan GJ, Anderson ID, Grant IS, Fearon KCH. Outcome of patients with abdominal sepsis treated in an intensive care unit. Br J Surg. 1995;82:524–9.CrossRefPubMed McLauchlan GJ, Anderson ID, Grant IS, Fearon KCH. Outcome of patients with abdominal sepsis treated in an intensive care unit. Br J Surg. 1995;82:524–9.CrossRefPubMed
6.
go back to reference Koperna T, Schulz F. Prognosis and treatment of peritonitis: Do we need new scoring systems? Arch Surg. 1996;131:180–6.CrossRefPubMed Koperna T, Schulz F. Prognosis and treatment of peritonitis: Do we need new scoring systems? Arch Surg. 1996;131:180–6.CrossRefPubMed
7.
go back to reference Pacelli F, Doglietto GB, Alfieri S, Piccioni E, Sgadari A, Gui D, et al. Prognosis in intra-abdominal infections. Multivariate analysis on 604 patients. Arch Surg. 1996;131:641–5.CrossRefPubMed Pacelli F, Doglietto GB, Alfieri S, Piccioni E, Sgadari A, Gui D, et al. Prognosis in intra-abdominal infections. Multivariate analysis on 604 patients. Arch Surg. 1996;131:641–5.CrossRefPubMed
8.
go back to reference Ohmann C, Yang Q, Hau T, Wacha H, the Peritonitis Study Group of the Surgical Infection Society Europe. Prognostic modelling in peritonitis. Eur J Surg. 1997;163:53–60.PubMed Ohmann C, Yang Q, Hau T, Wacha H, the Peritonitis Study Group of the Surgical Infection Society Europe. Prognostic modelling in peritonitis. Eur J Surg. 1997;163:53–60.PubMed
9.
go back to reference Montravers P, Gauzit R, Muller C, Marmuse JP, Fichelle A, Desmonts JM. Emergence of antibiotic-resistant bacteria in cases of peritonitis after intra-abdominal surgery affects the efficacy of empirical antimicrobial therapy. Clin Infect Dis. 1996;23:486–94.CrossRefPubMed Montravers P, Gauzit R, Muller C, Marmuse JP, Fichelle A, Desmonts JM. Emergence of antibiotic-resistant bacteria in cases of peritonitis after intra-abdominal surgery affects the efficacy of empirical antimicrobial therapy. Clin Infect Dis. 1996;23:486–94.CrossRefPubMed
10.
go back to reference Prabhu V, Shivani A. An overview of history, pathogenesis and treatment of perforated peptic ulcer disease with evaluation of prognostic scoring in adults. Ann Med Health Sci Res. 2014;4(1):22–9.PubMedCentralCrossRefPubMed Prabhu V, Shivani A. An overview of history, pathogenesis and treatment of perforated peptic ulcer disease with evaluation of prognostic scoring in adults. Ann Med Health Sci Res. 2014;4(1):22–9.PubMedCentralCrossRefPubMed
11.
go back to reference Sartelli M, Catena F, Ansaloni L, Leppaniemi A, Taviloglu K, van Goor H, et al. Complicated intra-abdominal infections in Europe: a comprehensive review of the CIAO study. World J Emerg Surg. 2012;7(1):36.PubMedCentralCrossRefPubMed Sartelli M, Catena F, Ansaloni L, Leppaniemi A, Taviloglu K, van Goor H, et al. Complicated intra-abdominal infections in Europe: a comprehensive review of the CIAO study. World J Emerg Surg. 2012;7(1):36.PubMedCentralCrossRefPubMed
12.
go back to reference Sartelli M, Catena F, Ansaloni L, Coccolini F, Corbella D, Moore EE, et al. Complicated intra-abdominal infections worldwide: the definitive data of the CIAOW Study. World J Emerg Surg. 2014;9:37.PubMedCentralCrossRefPubMed Sartelli M, Catena F, Ansaloni L, Coccolini F, Corbella D, Moore EE, et al. Complicated intra-abdominal infections worldwide: the definitive data of the CIAOW Study. World J Emerg Surg. 2014;9:37.PubMedCentralCrossRefPubMed
14.
go back to reference Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving Sepsis Campaign Guidelines Committee including The Pediatric Subgroup. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med. 2013;39(2):165–228.CrossRefPubMed Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving Sepsis Campaign Guidelines Committee including The Pediatric Subgroup. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med. 2013;39(2):165–228.CrossRefPubMed
15.
16.
go back to reference Merlino JI, Malangoni MA, Smith CM, Lange RL. Prospective randomized trials affect the outcomes of intraabdominal infection. Ann Surg. 2001;233(6):859–66.PubMedCentralCrossRefPubMed Merlino JI, Malangoni MA, Smith CM, Lange RL. Prospective randomized trials affect the outcomes of intraabdominal infection. Ann Surg. 2001;233(6):859–66.PubMedCentralCrossRefPubMed
17.
go back to reference Komatsu S, Shimomatsuya T, Nakajima M, Amaya H, Kobuchi T, Shiraishi S, et al. Prognostic factors and scoring system for survival in colonic perforation. Hepatogastroenterology. 2005;52:761–64.PubMed Komatsu S, Shimomatsuya T, Nakajima M, Amaya H, Kobuchi T, Shiraishi S, et al. Prognostic factors and scoring system for survival in colonic perforation. Hepatogastroenterology. 2005;52:761–64.PubMed
18.
go back to reference Koperna T, Semmler D, Marian F. Risk stratification in emergency surgical patients: is the APACHE II score a reliable marker of physiological impairment? Arch Surg. 2001;136(1):55–9.CrossRefPubMed Koperna T, Semmler D, Marian F. Risk stratification in emergency surgical patients: is the APACHE II score a reliable marker of physiological impairment? Arch Surg. 2001;136(1):55–9.CrossRefPubMed
19.
go back to reference Wacha H, Linder MM, Feldman U, Wesch G, Gundlach E, Steifensand RA. Mannheim peritonitis index – prediction of risk of death from peritonitis: construction of a statistical and validation of an empirically based index. Theor Surg. 1987;1:169–77. Wacha H, Linder MM, Feldman U, Wesch G, Gundlach E, Steifensand RA. Mannheim peritonitis index – prediction of risk of death from peritonitis: construction of a statistical and validation of an empirically based index. Theor Surg. 1987;1:169–77.
Metadata
Title
Global validation of the WSES Sepsis Severity Score for patients with complicated intra-abdominal infections: a prospective multicentre study (WISS Study)
Authors
Massimo Sartelli
Fikri M. Abu-Zidan
Fausto Catena
Ewen A. Griffiths
Salomone Di Saverio
Raul Coimbra
Carlos A. Ordoñez
Ari Leppaniemi
Gustavo P. Fraga
Federico Coccolini
Ferdinando Agresta
Asrhaf Abbas
Saleh Abdel Kader
John Agboola
Adamu Amhed
Adesina Ajibade
Seckin Akkucuk
Bandar Alharthi
Dimitrios Anyfantakis
Goran Augustin
Gianluca Baiocchi
Miklosh Bala
Oussama Baraket
Savas Bayrak
Giovanni Bellanova
Marcelo A. Beltràn
Roberto Bini
Matthew Boal
Andrey V. Borodach
Konstantinos Bouliaris
Frederic Branger
Daniele Brunelli
Marco Catani
Asri Che Jusoh
Alain Chichom-Mefire
Gianfranco Cocorullo
Elif Colak
David Costa
Silvia Costa
Yunfeng Cui
Geanina Loredana Curca
Terry Curry
Koray Das
Samir Delibegovic
Zaza Demetrashvili
Isidoro Di Carlo
Nadezda Drozdova
Tamer El Zalabany
Mushira Abdulaziz Enani
Mario Faro
Mahir Gachabayov
Teresa Giménez Maurel
Georgios Gkiokas
Carlos Augusto Gomes
Ricardo Alessandro Teixeira Gonsaga
Gianluca Guercioni
Ali Guner
Sanjay Gupta
Sandra Gutierrez
Martin Hutan
Orestis Ioannidis
Arda Isik
Yoshimitsu Izawa
Sumita A. Jain
Mantas Jokubauskas
Aleksandar Karamarkovic
Saila Kauhanen
Robin Kaushik
Jakub Kenig
Vladimir Khokha
Jae Il Kim
Victor Kong
Renol Koshy
Avidyl Krasniqi
Ashok Kshirsagar
Zygimantas Kuliesius
Konstantinos Lasithiotakis
Pedro Leão
Jae Gil Lee
Miguel Leon
Aintzane Lizarazu Pérez
Varut Lohsiriwat
Eudaldo López-Tomassetti Fernandez
Eftychios Lostoridis
Raghuveer Mn
Piotr Major
Athanasios Marinis
Daniele Marrelli
Aleix Martinez-Perez
Sanjay Marwah
Michael McFarlane
Renato Bessa Melo
Cristian Mesina
Nick Michalopoulos
Radu Moldovanu
Ouadii Mouaqit
Akutu Munyika
Ionut Negoi
Ioannis Nikolopoulos
Gabriela Elisa Nita
Iyiade Olaoye
Abdelkarim Omari
Paola Rodríguez Ossa
Zeynep Ozkan
Ramakrishnapillai Padmakumar
Francesco Pata
Gerson Alves Pereira Junior
Jorge Pereira
Tadeja Pintar
Konstantinos Pouggouras
Vinod Prabhu
Stefano Rausei
Miran Rems
Daniel Rios-Cruz
Boris Sakakushev
Maria Luisa Sánchez de Molina
Charampolos Seretis
Vishal Shelat
Romeo Lages Simões
Giovanni Sinibaldi
Matej Skrovina
Dmitry Smirnov
Charalampos Spyropoulos
Jaan Tepp
Tugan Tezcaner
Matti Tolonen
Myftar Torba
Jan Ulrych
Mustafa Yener Uzunoglu
David van Dellen
Gabrielle H. van Ramshorst
Giorgio Vasquez
Aurélien Venara
Andras Vereczkei
Nereo Vettoretto
Nutu Vlad
Sanjay Kumar Yadav
Tonguç Utku Yilmaz
Kuo-Ching Yuan
Sanoop Koshy Zachariah
Maurice Zida
Justas Zilinskas
Luca Ansaloni
Publication date
01-12-2015
Publisher
BioMed Central
Published in
World Journal of Emergency Surgery / Issue 1/2015
Electronic ISSN: 1749-7922
DOI
https://doi.org/10.1186/s13017-015-0055-0

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