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Related Experiment Videos

APACHE II score and abdominal sepsis. A prospective study.

J M Bohnen1, R A Mustard, S E Oxholm

  • 1Department of Surgery, Wellesley Hospital, Toronto, Ontario, Canada.

Archives of Surgery (Chicago, Ill. : 1960)
|February 1, 1988
PubMed
Summary

The Acute Physiology and Chronic Health Evaluation (APACHE II) score effectively predicts mortality in patients with abdominal sepsis. Steroid use was also identified as an independent risk factor for mortality in this patient population.

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Area of Science:

  • Critical care medicine
  • Surgical outcomes
  • Clinical scoring systems

Background:

  • Intra-abdominal sepsis management requires accurate pretreatment patient stratification.
  • Physiologic scoring systems are emerging tools for this purpose.
  • The Acute Physiology and Chronic Health Evaluation (APACHE II) score is one such system.

Purpose of the Study:

  • To prospectively validate the APACHE II scoring system for predicting mortality in patients with intra-abdominal sepsis.
  • To investigate the independent association of steroid use with mortality in this cohort.

Main Methods:

  • Prospective correlation of APACHE II scores with mortality in 100 patients hospitalized for generalized peritonitis or abdominal abscess.
  • Recording of steroid use due to suspected impact on mortality and physiologic response.

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  • Stepwise discriminant analysis to identify independent predictors of mortality.

    • Main Results:

    • Thirty-one out of 100 patients died.
    • APACHE II scores were independently associated with mortality.
    • Steroid use was also independently associated with mortality, with 12 of 19 steroid recipients dying.

    Conclusions:

    • The APACHE II score is a valid tool for pretreatment risk stratification in abdominal sepsis.
    • Steroid administration is an independent risk factor contributing to increased mortality in abdominal sepsis.