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ISSN 1561-3046 (Electronic)

2022, Number 1

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Rev Cub Med Mil 2022; 51 (1)

Apache-II superiority for the prognosis of mortality after urgent abdominal surgery: multicentric study

de Dios SMC, Tamargo BTO, Lombardo VTA, Mezquia PN, Illodo HOL

Language: Spanish
References: 29
Page:
PDF size: 279.46 Kb.


ABSTRACT

Introduction: The mortality prognosis of patients after abdominal surgery demands effective and reproducible aid systems.
Objective: To compare the efficacy of three procedures in predicting mortality in emergency laparotomy patients.
Methods: Prospective cohort observational multicenter study with 200 patients in the postoperative period of urgent major abdominal surgery assisted at the “Miguel Enríquez”, “Carlos J Finlay”, “Hermanos Ameijeiras” hospitals between November 2016 and November 2018. Mean, standard deviation median and interquartile range measures were applied for the comparison between living and deceased and the probability of dying was calculated according to the model that includes both procedures. Discrimination capacity was evaluated by constructing three curves of receiver operational characteristics, areas under the curves and confidence intervals were determined.
Results: Total mortality was 38% and significantly prevailed in older patients, with a greater number of complications, reoperated patients, and those with septic findings during reoperation. Predictive power was higher for APACHE II compared to the other two procedures (area under the curve 0.912, CI 95%: 0.840-0.933, p< 0.001).
Conclusions: APACHE II is an effective and reliable model for predicting mortality in patients in the postoperative period of major emergency surgery, which makes it highly recommended for this purpose.


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