Apache II scoring in predicting surgical outcome in patients of perforation peritonitis

Authors

  • Anand Agarwal Department of Surgery, Dr. S.N. Medical College Jodhpur, Rajasthan, India
  • Ganpat Singh Choudhary Department of Surgery, Dr. S.N. Medical College Jodhpur, Rajasthan, India
  • Mansingh Bairwa Department of Surgery, Dr. S.N. Medical College Jodhpur, Rajasthan, India
  • Amit Choudhary Department of Surgery, Dr. S.N. Medical College Jodhpur, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-2902.isj20172790

Keywords:

APACHE II score, Exploratory laparotomy, Outcome, Perforation peritonitis

Abstract

Background: Many scoring systems have been found useful in predicting the outcome in critically ill patients, amongst them acute physiology and chronic health evaluation score (APACHE II) appeared to be the most widely used and had a general acceptance in assessing the critically ill patients, for its easy applicability and ability to predict outcome.

Methods: To predict the surgical outcome in patients of perforation peritonitis APACHE II scoring done in every diagnosed case of perforation peritonitis in a prospective study from January 2015 to June 2016 was done. 100 patients with perforation peritonitis fulfilling the inclusion and exclusion criterion underwent exploratory laparotomy in Mahatma Gandhi hospital, Dr. S.N. Medical college, Jodhpur, Rajasthan, India.

Results: In current study, 69 patients were in the low risk group (apache score 0-5) and 24 patients were in the medium risk group (Apache score 6-10) and 7 patients were in the high-risk group (Apache score 11-16). Of these 100 % patients in low risk group and 95.8% patients in medium risk group were discharged in satisfactory manner and 100% patients expired in high risk group.

Conclusions: APACHE II score correlated well with the outcome in current study, it also correlated well with the hospital and ICU stay.

Author Biography

Anand Agarwal, Department of Surgery, Dr. S.N. Medical College Jodhpur, Rajasthan, India

Final Year Resident, General Surgery Department, Dr.S.N.Medical College, Jodhpur, Rajasthan

References

Adesunkanmi ARK, Ajao OG. The prognostic factors in typhoid ideal perforation. A prospective study of 50 patients. IO J Roy Coll Surg Edinb. 1997;42:395-9

Bohnen J, Boulanger, Meakins JL, McLean PH. Prognosis in generalized peritonitis: Relation to cause and risk factors. Arch Surg. 1983;118:285-90.

Ponling GA, Sim AJW, Dudley HAF. Comparison of local and systemic of sepsis in predicting survival. Br J Surg. 1987;74:750-2.

Bion J. Outcome in intensive care. BMJ. 1993;307:953-4.

Kanus WA, Dropper EA, Wagner DR, Zimmerman JE. APACHE severity of disease classification system. Crit Care Med. 1985;13:818-29.

Civelta JM, Hudson-Civeua JA, Nelson LD. Evaluation of APACHE II for cost containment and quality assurance. Ann Surg. 1990;212:266-76.

Baker SP, O'Neil 'B, Haddon WQ, Long WB. The injury severity score. A method for describing pattern of patients with multiple injuries and evaluating emergency cases. J Trauma. 1974;14:187.

Kitara DL, Kakande I, Mugisa BD. POSSUM scoring in patients undergoing laparotomy in Mulago Hospital. East Central African Journal Surgery. 2007;12(2):133-42.

Mathur GM, Sharma R. A study of typhoid fever in Jaipur, India. Trop Geog Med. 1971; 23;329-34.

Huttunen R, Kairaluoma MI, Mokka RE, Larmi TK. Non-traumatic perforations of the small intestine. Surg. 1977;81(2):184-8.

Petrosillo N, Drapeau CM, Nicastri E, Martini L, Ippolito G, Morro Ml et al. Surgical site infection in Italian hospital: a prospective multicentre study. BMC Infect Dis. 2008;8:34.

Archampong EQ. Operative treatment of typhoid perforation of the bowel. Br Med J. 1969;3:173-276.

Afridi SP, Malik F, Rahman SU, Shamim S, Khursheed AS. Spectrum of perforation peritonitis in Pakistan: 300 cases Eastern experience. World J Emerg Surg. 2008;3:31.

Jhobta RS, Attari AK, Kaushik R, Sharma R, Jhobta A. Spectrum of perforation peritonitis in India – review of 504 consecutive cases. World J Emerg Surg. 2006;1:26.

Dorairajan LN, Gupta S, Deo SV,Chumber S,Sharma L.Peritonitis in India-a decade’s experience. Trop Gastroenterol. 1995;16(1):3338.

Sahu SK, Gupta A, Sachan PK, Bahl DV. Outcome of secondary peritonitis based on Apache II Score. Internet J Surg. 2008;14:2.

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Published

2017-06-22

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Original Research Articles