APACHE-II scoring system in perforative peritonitis

Abstract Background Prospective assessment of the Acute Physiology and Chronic Health Evaluation–II (APACHE-II) scoring system of stratification of disease severity has been shown to provide objective discrimination between low-risk and high-risk groups of patients with intra-abdominal sepsis. The c...

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Bibliographic Details
Published in:The American journal of surgery 2007-10, Vol.194 (4), p.549-552
Main Authors: Kulkarni, Srikanth V., M.S, Naik, Anitha S., M.S, Subramanian, Nirmala, M.S
Format: Article
Language:English
Subjects:
Abdomen
Adult
APACHE
APACHE-II scoring system
Appendicitis
Biological and medical sciences
Female
Gastroenterology. Liver. Pancreas. Abdomen
General aspects
Hollow viscus perforation
Hospitals
Humans
Intra-abdominal sepsis
Male
Medical sciences
Middle Aged
Mortality
Mortality risk
Other diseases. Semiology
Patients
Peritonitis - etiology
Peritonitis - mortality
Risk Assessment
Rupture, Spontaneous
Software
Stratification of disease severity
Studies
Surgery
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Summary:Abstract Background Prospective assessment of the Acute Physiology and Chronic Health Evaluation–II (APACHE-II) scoring system of stratification of disease severity has been shown to provide objective discrimination between low-risk and high-risk groups of patients with intra-abdominal sepsis. The current study was undertaken to evaluate the performance of APACHE-II score in prediction of mortality risk in patients with peritonitis due to hollow viscus perforation. Study Design Fifty patients admitted to a teaching hospital with peritonitis due to hollow viscus perforation were prospectively studied over a 2-year period. APACHE-II points were assigned to all patients in order to calculate their individual risk of mortality before undergoing emergency surgery. The accuracy in outcome prediction of the APACHE-II system was assessed by means of receiver operating characteristic (ROC) curve and the Pearson correlation coefficient and its significance test. Results Of the 50 patients admitted during the study period, there were 42 (84%) survivors and 8 (16%) nonsurvivors. Mean APACHE-II score of the study population was 11.38 with a range of 1 to 23. The predicted death rate was 23% and the observed death rate was 16%. Mean APACHE-II score in survivors was 9.88, whereas in nonsurvivors it was 19.25. Using ROC analysis, the area under the curve was found to be .984. Correlation of APACHE-II score and predicted death rate showed perfect correlation, with r = .99 and P
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2007.01.031