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Description

Dupont et al identified risk factors associated with mortality in critically ill patients who develop polymicrobial peritonitis containing a Candida species. This can help identify patients who may require more aggressive management. The authors are from University Hospital Bichat-Claude Bernard in Paris.


Parameters identified on multivariate analysis:

(1) APACHE II score

(2) respiratory failure

(3) source

(4) direct smear of peritoneal fluid

 

Parameters

Findings

Points

APACHE II score

<= 17

0

 

> 17

1

respiratory failure

absent

0

 

present

1

source

lower GI tract

0

 

upper GI tract

1

direct smear

negative for yeast

0

 

positive for yeast

1

 

where:

• A source cephalad to the mesocolon (stomach, duodenum, biliary tract) was considered upper gastrointestinal, else lower.

 

X =

= (3.35 * (points for APACHE II score)) + (2.36 * (points for respiratory failure)) + (2.05 * (points for source)) + (1.56 * (points for direct smear)) - 3.79

 

probability of death =

= 1 / (1 + EXP((-1) * X))


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