Background:

Despite the improvement in care, recognition and management of multiple organ failure, availability of new antibiotics, advances in diagnostic techniques, and the decision to reintervention in a critically ill patient ultimately depend on a medical judgment. The use of the Abdominal Reoperation Predictive Index (ARPI) among patients with a possibility of reintervention allows the estimation of mortality being susceptible to be abated, reducing the time elapsed between the first operation and the relaparotomy, as well as a shorter stay in intensive care units.

Objective:

The objectives of this study were to determine the degree of certainty of the ARPI to diagnose the need for reoperation in patients with abdominal sepsis.

Materials and Methods:

An observational, descriptive, cross-sectional, retrospective study of patients from the General Hospital of Mexico “Eduardo Liceaga” belonging to the clinic of integral care of abdominal sepsis, from January to June 2016, with diagnosis of abdominal sepsis operated urgently by secondary peritonitis.

Results:

A total of 94 patients were included, 58.5% of male (n = 55) and 41.5% of female (n = 39), with an average age of 48.1 years (Standard mean [SD] ± 17.4). The most frequently injured organ in the initial surgery was the cecal appendix in 39 cases (41.5%) followed by the small intestine in 21 cases (22.3%). Those cases with ARPI scores > 21 were operated on 6 of 8, corresponding to 75% with a score > 21, while of the cases with ARPI score < 20 points reoperated 23 of 86, corresponding to 26.7% with a score < 20 points. Fisher’s exact test, p = 0.01, statistically significant.

Conclusions:

The ARPI may be helpful in guiding the decision-making of laparotomy in patients diagnosed with secondary peritonitis.

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