Eosinopenia as a Prognostic Marker in Patients with Peritonitis. (28th August 2012)

• Record Type: Journal Article
• Authors: Jagdeesh, T. S.; Mishra, Arpan; Saxena, Arjun; Sharma, Dhananjaya
• Other Names: Calleri G. Academic Editor.; Çiftçi E. Academic Editor.; Peoc'H K. Academic Editor.; Pourshafie M. R. Academic Editor.; Su F. Academic Editor.
• Is Part Of: ISRN infectious diseases. Volume 2013(2013)
• Publication Date: 2012-08-28
• Subjects: Communicable diseases -- Periodicals; 616.9
• DOI: 10.5402/2013/540948
• Languages: English
• ISSNs: 2090-8725

Abstract

Abstract : Introduction . Eosinopenia has been, recently, found to have strong association with inflammatory-syndrome-associated bacterial infectious diseases. This prompted us to investigate its use as a prognostic marker in perforation peritonitis patients. Methods . A prospective study of perforation peritonitis patients admitted to the surgical wards at a teaching hospital in Central India was conducted. jabalpur prognostic score (JPS, a simplified prognostic score for developing countries), C-reactive protein (mg/dL) levels, and absolute eosinophil counts (cells/cmm) were measured on admission. Their correlation with inpatient mortality was evaluated. Results . 94 consecutive patients were studied, peptic (n = 55 ) followed by ileal, colonic, and appendicular perforations were the commonest cause of peritonitis. 13/94 died; ileal perforations had the highest (n = 6 /34, 17.6%) mortality. When correlated with mortality, univariate analysis showed JPS, CRP, and AEC to be accurate prognostic markers (P < 0.00001 ), while multivariate analysis showed only AEC to be accurate (P = 0.03 ). At a cut-off value of 8, JPS showed sensitivity of 77%, a specificity of 85.1%, positive predicted value (PPV) of 55%, negative predicted value (NPV) of 95%, and area under receiver operating curve (AUROC) was 0.86. CRP level, at a cut-off value of 7.4, yielded sensitivity of 92.3%, specificity of 79%, PPV of 41%, NPV of 98%, and AUROC was 0.93. At a cut-off value of 45, the sensitivity of the AEC was 92.3%, specificity of 92.5%, PPV 85%, NPV of 99%, and AUROC was 0.96. Discussion . Eosinopenia on admission is a prognostic marker of mortality in patients with peritonitis.