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Original Research

Med Arch. 2011; 65(2): 82-85


Apache II Scoring System is Superior in the Prediction of the Outcome in Critically Ill Patients with Perforative Peritonitis

Samir Delibegovic, Dragana Markovic, Samir Hodzic.




Abstract

Background. There are several scoring systems used in the prediction of outcome in critically ill patients. This study was undertaken to evaluate APACHE II, SAPS I, Sepsis score, MOF, TISS-28 and MPI scoring systems in prediction of the outcome in patients with perforative peritonitis. Patients and methods. The prospective study of 145 patients of both sexes with perforative peritonitis was performed. The main outcome of study was peritonitis-related death. Variables necessary for calculation of the scoring systems were recorded at the initial admission to the hospital and the third and seventh day of hospitalization, except Mannheim Peritonitis Index, which was calculated during the first 24 hours after hospitalization. Cut-off points were specified and all values greater than cut-off points were taken to predict death. Sensitivity and specificity are graphically shown for the different values of cut-off points and represented with the receiver-operating characteristic curve. The difference in the area below the curve between scoring systems was statistically compared. Results. The area under the curve for the first postoperative day was 0.87 for TISS-28 score, 0.86 for APACHE II score, 0.83 for MOF and SAPS I, 0.72 for MPI and 0,70 for Sepsis score. This demonstrated that TISS-28 and APACHE II are significantly better than other systems (p

Key words: peritonitis, APACHE II, Surgical Intensive Care Unit.






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