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• W2010028896 abstract "EDITOR: The APACHE II and APACHE III scoring systems (1985 and 1990), for the evaluation of the severity of disease and outcome in special groups of intensive care patients, may also be applied to other selected clinical settings, e.g. acute myocardial infarction [1], septic shock [2], acute renal failure [3], cardiovascular surgery [4] and liver transplantation [5]. Accordingly, we analysed APACHE II and III scores before surgery, for their predictive value regarding postoperative mortality in patients presenting for emergency surgery. In a prospective, descriptive study, we collected data for over 3 months for all patients scheduled for emergency surgery in the departments of trauma and abdominal surgery, neurosurgery, vascular and plastic surgery, orthopaedic and chest surgery in the University Hospital of Graz. Information required for the calculation of the APACHE II and III scores was obtained immediately before the induction of anaesthesia. Demographic data, duration of anaesthesia and surgery were recorded. The follow-up continued until either discharge from hospital or death. All data are shown as mean and standard deviations and compared by Student's unpaired t-test. Evaluation of sensitivity and specificity of the scoring systems was obtained by Relative Operating Characteristic (ROC) analysis. P < 0.05 was considered significant. One hundred and twenty-seven patients were included in our study. Ten patients (7.87%) died in hospital (the non-survivor group); the remaining 117 patients formed the survivor group. The main indications for emergency surgery were abdominal pathology and trauma. No differences between the survivor and non-survivors were found concerning gender, duration of hospital stay, anaesthesia and/or surgery. However, differences were found for age (P < 0.01), ASA physical status (P < 0.05), APACHE II (P < 0.001) and APACHE III (P < 0.001). Serum protein, bilirubin, glucose and urea concentrations also differed after operation (P < 0.01). ROC-analysis for APACHE II and III demonstrated a high reliability for both scoring systems. Sensitivity (0.8889) and specificity (0.7857) of the APACHE II, and sensitivity (0.8889) and specificity (0.8125) of the APACHE III proved to be either identical or minimally different. We believe, despite the relatively small numbers of patients and especially the small mortality, that our data seem to show evidence that both scoring systems - evaluated immediately before emergency surgery - demonstrate an excellent sensitivity and specificity for postoperative mortality. Furthermore the pathological values of metabolic variables before operation correlated with a higher mortality. The use of APACHE III did not show any increased benefit compared to APACHE II. H. KRENN C. DORN Department of Anaesthesiology and Intensive Care Medicine, Karl Franzens University of Graz, Austria R. D. FITZGERALD Ludwig Boltzmann Institute for Economics of Medicine in Anaesthesia and Intensive Care, Vienna City Hospital Lainz, Austria H. POJER G. RUMPOLD-SEITLINGER W. F. LIST Department of Anaesthesiology and Intensive Care Medicine, Karl Franzens University of Graz, Austria" @default.
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• W2010028896 date "2000-08-01" @default.
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• W2010028896 title "Prognostic value of APACHE II and III for preoperative evaluation of emergency surgery patients" @default.
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• W2010028896 doi "https://doi.org/10.1046/j.1365-2346.2000.00716.x" @default.
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