Key result
The APACHE II scoring system was the most valid and accurate model for predicting mortality in geriatric patients undergoing emergency abdominal surgery, demonstrating an odds ratio of 4.00 and 96% sensitivity.
Why the study?
Does the APACHE II scoring system better predict mortality in geriatric patients undergoing emergency abdominal surgery compared to other scoring systems?
Observational (n=112)
No
Does the APACHE II scoring system better predict mortality in geriatric patients undergoing emergency abdominal surgery compared to other scoring systems?
Odds Ratio: 4 (95% CI 2.8–5.19)
p-value: p=0.0001
In geriatric patients undergoing emergency abdominal surgery, the APACHE II score is the most accurate predictor of mortality among commonly used clinical scoring systems.
APACHE II may aid mortality prediction in geriatric emergency abdominal surgery; leaves open prospective validation against alternatives.
BACKGROUND: Accurate measurement of surgical outcomes, proper evaluation of hospitals and surgeons regardless of case can be performed by mortality prediction models. The aim of this study was to analyze factors affecting mortality, present our clinical experience and patient profile and evaluate different scoring systems in use of these patients. METHODS: A retrospective review of one hundred and twelve geriatric patients who underwent major abdominal emergency surgery between 2004 and 2008 was performed. APACHE II, ODIN, SAPS II expanded, P-POSSUM, Manheim peritonitis and Charlson comorbidity index, Goldman and ASA scores were calculated using patient data. Sensitivity, positive predictive value and Odd's ratio were calculated to predict the mortality for these scoring systems. RESULTS: The overall mortality rate for our patients was found 33.9%. The factors affecting mortality in this study were found to be the duration of initial complaint, requirement of intensive care unit, requirement of mechanical ventilation and its duration, the presence of coexisting disease and peritonitis. CONCLUSION: According to our study, in this particular group of patients, APACHE II scoring system is more valid and accurate in estimating the mortality risk when compared to other scoring systems.
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Murat Özban (2015) conducted an observational in Geriatric emergency abdominal surgery (n=112). APACHE II scoring system vs. Other scoring systems (P-POSSUM, ODIN, SAPS II Expanded) was evaluated on Mortality prediction (OR 4.00, 95% CI 2.80-5.19, p=0.0001). The APACHE II scoring system was the most valid and accurate model for predicting mortality in geriatric patients undergoing emergency abdominal surgery, demonstrating an odds ratio of 4.00 and 96% sensitivity.
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