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Eur J Surg. 1999 Aug;165(8):730-5.

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

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  • 1Clinica di Semeiotica e Metodologia Chirurgica, Universit√† degli Studi di Ancona, I.N.R.C.A.-I.R.C.C.S., Italy.

Abstract

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.

[PubMed - indexed for MEDLINE]
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