title: Evaluation of prognostic factors and scoring system in colonic perforation.
abstract: OBJECTIVE
  To study the significance of scoring systems assessing severity and prognostic factors in patients with colonic perforation.
  
  
  METHODS
  A total of 26 patients (9 men, 17 women; mean age 72.7+/-11.6 years) underwent emergency operation for colorectal perforation in our institution between 1993 and 2005. Several clinical factors were measured preoperatively and 24 h postoperatively. Acute physiology and chronic health evaluation II (APACHE II), Mannheim peritonitis index (MPI) and peritonitis index of Altona (PIA II) scores were calculated preoperatively.
  
  
  RESULTS
  Overall postoperative mortality rate was 23.1% (6 patients). Compared with survivors, non-survivors displayed low blood pressure, low serum protein and high serum creatinine preoperatively, and low blood pressure, low white blood cell count, low pH, low PaO2/FiO2, and high serum creatinine postoperatively. APACHE II score was significantly lower in survivors than in non-survivors (10.4+/-3.84 vs 19.3+/-2.87, P=0.00003). Non-survivors tended to display high MPI score and low PIA II score, but no significant difference was identified.
  
  
  CONCLUSIONS
  Pre- and postoperative blood pressure and serum creatinine level appear related to prognosis of colonic perforation. APACHE II score is most associated with prognosis and scores>or=20 are associated with significantly increased mortality rate.
authors.affiliation: Department of Surgery 2, Ehime University School of Medicine, Shitsukawa, Toon-city, Ehime 791-0295, Japan. atsushi@m.ehime-u.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Horiuchi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Takashi
authors.initials: T
authors.lastname: Doi
authors.forename: Kouichi
authors.initials: K
authors.lastname: Sato
authors.forename: Syungo
authors.initials: S
authors.lastname: Yukumi
authors.forename: Motohira
authors.initials: M
authors.lastname: Yoshida
authors.forename: Yuji
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sugishita
authors.forename: Kanji
authors.initials: K
authors.lastname: Kawachi
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003106:Colon / Q000293:injuries*; D005260:Female; D017583:Hemodiafiltration; D006801:Humans; D007416:Intestinal Perforation / Q000401:mortality* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis