Preoperative APACHE II and ASA scores in patients having major general surgical operations: prognostic value and potential clinical applications

Objective: To assess the prognostic value of the APACHE II score and the American Society of Anesthesiologists (ASA) classification system in preoperative evaluation of patients. Design: Prospective study. Setting: University hospital, Italy. Subjects: 187 consecutive patients undergoing elective or...

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Bibliographic Details
Published in:The European journal of surgery 1999-08, Vol.165 (8), p.730-735
Main Authors: Goffi, Luigi, Saba, Vittorio, Ghiselli, Roberto, Necozione, Stefano, Mattei, Antonella, Carle, Flavia
Format: Article
Language:English
Subjects:
Aged
APACHE
Biological and medical sciences
Elective Surgical Procedures - statistics & numerical data
Emergencies
Female
Humans
Logistic Models
Male
Medical sciences
Miscellaneous
Preoperative Care - statistics & numerical data
Prognosis
Prospective Studies
ROC Curve
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgical Procedures, Operative - statistics & numerical data
Treatment Outcome
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Summary:Objective: To assess the prognostic value of the APACHE II score and the American Society of Anesthesiologists (ASA) classification system in preoperative evaluation of patients. Design: Prospective study. Setting: University hospital, Italy. Subjects: 187 consecutive patients undergoing elective or emergency major general surgical operations. Interventions: Patients were evaluated preoperatively using both indices. Main outcome measures: Morbidity and mortality within 30 days. Results: Logistic regression and ROC curve analyses showed that the APACHE II score predicted morbidity and mortality well; it was superior to the ASA system in predicting outcome (area under the curve 0.894 for the APACHE II index, 0.777 for the ASA system; p < 0.001). The APACHE II score without its age points (area 0.888) had the same prognostic value as the complete score (area 0.894; p = 0.55). Conclusions: The APACHE II score may help clinicians to evaluate preoperatively the risk of postoperative morbidity and death after major general surgical operations. Age does not seem to have a specific weight. Copyright © 1999 Taylor and Francis Ltd.
ISSN:1102-4151
1741-9271
DOI:10.1080/11024159950189483