APACHE II in surgical lung carcinoma patients

Area of Science:

• Thoracic Surgery
• Critical Care Medicine
• Geriatric Medicine

Background:

• Extensive advancements in thoracic surgery now enable treatment for elderly patients with complex health issues.
• Evaluating outcomes in this patient group is challenging due to diverse pathophysiologic alterations and reliance on intensive medical support.
• A robust severity of disease classification system is crucial for risk stratification, treatment indication, and outcome prediction in elderly and chronically ill surgical patients.

Purpose of the Study:

• To evaluate the effectiveness of the APACHE II (Acute Physiology and Chronic Health Evaluation II) severity of disease classification system.
• To assess the system's ability to predict mortality risk in high-risk patients undergoing thoracic surgery.
• To determine the system's accuracy in guiding surgical indications and predicting patient outcomes.

Main Methods:

• The APACHE II severity of disease classification system was applied to 59 consecutive high-risk patients.
• Hospital admission characteristics and hospital mortality data were analyzed.
• The system's performance was evaluated based on predicted mortality rates and actual outcomes.

Main Results:

• The predicted mortality rate for the high-risk patient cohort was 12.44%.
• The total mortality ratio of actual deaths to predicted deaths was 0.94.
• The APACHE II system demonstrated a good correct classification rate, sensitivity, and specificity in this population.

Conclusions:

• The APACHE II scoring system is a valuable tool for assessing pre-treatment risk in elderly and chronically ill patients undergoing thoracic surgery.
• The system aids in determining appropriate surgical indications and predicting patient outcomes.
• The findings support the utility of the APACHE II system in managing high-risk surgical patients.