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Preoperative APACHE II and ASA scores in patients having major general surgical operations: prognostic value and
1Clinica di Semeiotica e Metodologia Chirurgica, Università degli Studi di Ancona, I.N.R.C.A.-I.R.C.C.S., Italy.
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.
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