The World Society of Emergency Surgery Sepsis Severity Score shows no prognostic superiority over the Mannheim Peritonitis Index in patients with complicated intra-abdominal infections

Abstract

Introduction: Although various scoring systems are already available for early prognostic evaluation of patients with complicated intra-abdominal infections (cIAIs), none has shown the ideal characteristics in everyday practice. In this study, we aimed to find the most reliable prognostic score in patients with cIAIs. Methods: This retrospective study involved 110 patients with cIAIs admitted to the Department of Surgical Diseases at University Hospital, “Prof. Dr. Stoyan Kirkovich” Stara Zagora from January 2017 to July 2019. We compared the prognostic values of Mannheim Peritonitis Index (MPI), World Society of Emergency Surgery Sepsis Severity Score (WSES SSS), quick sequential (sepsis-related) organ failure assessment score (qSOFA), and systemic inflammatory response syndrome (SIRS) using area under receiver operating characteristics (AUROC) curves. Bivariate correlation analysis was used to evaluate the association between scoring systems and the final outcome. Results: The observed in-hospital mortality was 22.7%. Significant correlations were found between MPI and outcome (r = 0.500, p < 0.001), WSES SSS and outcome (r = 0.483, p < 0.001), and qSOFA and outcome (r = 0.356, p < 0.001). Of all the scoring systems, MPI showed the best prognostic performance (AUROC = 0.844, 95% confidence interval (CI) = 0.763–0.924). The identified sensitivity and specificity for MPI cut-off value >25 points were 80% and 77.6%, respectively. Conclusion: The MPI is still one of the best options for prognostic evaluation of patients with cIAIs.