Eosinopenia as a Prognostic Marker in Patients with Peritonitis

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 () followed by ileal, colonic, and appendicular perforations were the commonest cause of peritonitis. 13/94 died; ileal perforations had the highest (/34, 17.6%) mortality. When correlated with mortality, univariate analysis showed JPS, CRP, and AEC to be accurate prognostic markers (), while multivariate analysis showed only AEC to be accurate (). 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.