APACHE III, unlike APACHE II, predicts posthepatectomy mortality in patients with biliary tract carcinoma. Acute Physiology and Chronic Health Evaluation.
OBJECTIVE
To evaluate Acute Physiology and Chronic Health Evaluation (APACHE) II and APACHE III scores after liver resection and to elucidate whether APACHE III is more accurate as a predictor of posthepatectomy mortality.


METHODS
Retrospective, cohort study.


METHODS
Intensive care unit in a tertiary care university hospital.


METHODS
Consecutive series of 101 patients admitted to the intensive care unit immediately after elective hepatectomy for biliary tract carcinoma.


METHODS
None.


RESULTS
APACHE II and APACHE III scores were calculated on postoperative days 1, 2, and 3. The 101 subjects were classified into three groups: a) survivors without posthepatectomy liver failure (n = 69); b) survivors with liver failure (n = 17); and c) nonsurvivors with liver failure (n = 15). APACHE III, but not APACHE II, was significantly different between the three groups at all time points. An increased APACHE III score correlated with an increased risk of death, while death did not correlate with APACHE II score.


CONCLUSIONS
In posthepatectomy patients with biliary tract carcinoma, APACHE III, unlike APACHE II, is sufficiently reliable for clinical use to stratify patients and predict mortality.
First Department of Surgery, Nagoya University School of Medicine, Japan.
N
N
Hamahata
M
M
Nagino
Y
Y
Nimura
D018806:APACHE; D000328:Adult; D000368:Aged; D001661:Biliary Tract Neoplasms / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods / Q000401:mortality*; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D017093:Liver Failure / Q000209:etiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016019:Survival Analysis