A proposed classification of intra-abdominal infections. Stratification of etiology and risk for future therapeutic trials.
A proposed classification of intra-abdominal infections. Stratification of etiology and risk for future therapeutic trials.
复制标题
腹腔内感染的拟议分类。
DOI：
10.1001/archsurg.1984.01390240010002
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发表时间：
1984
影响因子：
--
通讯作者：
R. Simmons
中科院分区：
文献类型：
--
作者：
J. Meakins;J. Solomkin;M. Allo;E. Dellinger;R. Howard;R. Simmons
对超腹部感染的认真研究得出的死亡率范围从 3.5%（评估 1,275 名患者的抗生素研究的综合结果）到多器官衰竭研究中的 60% 以上。在回顾这些研究时，很明显，在“严重腹腔内感染”的保护下，正在研究不同的疾病、过程和患者。我们定义了一个结合了腹内感染的解剖学和功能性方法的二项式分类。腹腔内感染有十种病因学分类，并结合急性生理评分 (APS)，测量疾病的严重程度，分为三个等级。对于患有未分化腹腔内脓毒症的患者，患者将被分为 I、II、III 或 IV 级，并添加评分 A、B 或 C。 V-X 组中的每个组定义了特定的感染类别，也可以使用 APS，该 APS 已在重症监护患者和腹腔内感染患者中得到验证。预计使用这种方法将提供一种统一评估患者群体的技术，其中正在研究治疗腹内感染的药物或技术方法。所研究的患者将更加明确，并且一个中心与另一个中心的研究将具有可比性。
Serious studies of ultra-abdominal infections have yielded a mortality that ranges from 3.5% (a composite of antibiotic studies evaluating 1,275 patients) to more than 60% in studies of multiple-organ failure. In reviewing these studies, it is apparent that under the umbrella of "serious intra-abdominal infection," different diseases, processes, and patients are being studied. We define a binomial classification incorporating both an anatomic and a functional approach to intra-abdominal infection. There are ten etiologic classifications of intra-abdominal infections combined with an acute physiologic score (APS), measuring severity of illness, in three gradations. In the patient with undifferentiated intra-abdominal sepsis, the patient will be in class I, II, III, or IV, with a score, A, B, or C, added. Each of the groups V-X, defining a specific infectious category, can also use the APS, which has been verified in patients in intensive care and in those with intra-abdominal infection. It is anticipated that using this approach will provide a technique to evaluate patient groups uniformly in which drug or technical approaches to the management of intra-abdominal infections are being studied. The patients being studied will be more clearly defined, and studies will be comparable from one center to another.