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


METHODS
Prospective study.


METHODS
University hospital, Italy.


METHODS
187 consecutive patients undergoing elective or emergency major general surgical operations.


METHODS
Patients were evaluated preoperatively using both indices.


METHODS
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.
Goffi
L
L
Clinica di Semeiotica e Metodologia Chirurgica, Università degli Studi di Ancona, I.N.R.C.A.-I.R.C.C.S., Italy.
Saba
V
V
Ghiselli
R
R
Necozione
S
S
Mattei
A
A
Carle
F
F
D018806:APACHE; D000368:Aged; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D004630:Emergencies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D011300:Preoperative Care / Q000706:statistics & numerical data; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data; D016896:Treatment Outcome