Makela et al reported prognostic factors for elderly adults with perforated sigmoid diverticulitis. These can help to identify a patient who may require more aggressive management. The authors are from Oulu University in Finland
Complication rate: 33%
Overall mortality rate: 8%
The mortality rate was 14% for patients over 70 years of age and 4% for those less than 70 years.
Prognostic factors, primarily for those less than 70 years of age:
(1) Mannheim Peritonitis Index (MPI), from 0 to 47 (poor prognosis if >= 21)
(2) ASA score
(3) Hinchey stage (I to IV)
(4) malnutrition
Prognostic Factor
Finding
Points
ASA
I or II
0
III, IV or V
1
Mannheim Peritonitis Index
< 21
0
>= 21
1
Hinchey stage
I or II
0
III or IV
1
malnutrition
no
0
yes
1
where:
• Patients with ASA V did poorly.
number of prognostic factors =
= SUM(points for all of the prognostic factors)
Interpretation:
• minimum number: 0
• minimum number: 4
• The prognosis tends to be worse as the number of prognostic factors increase.
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