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Article
December 1984

A Proposed Classification of Intra-abdominal InfectionsStratification of Etiology and Risk for Future Therapeutic Trials

Arch Surg. 1984;119(12):1372-1378. doi:10.1001/archsurg.1984.01390240010002
Abstract

• 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.

(Arch Surg 1984;119:1372-1378)

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