Prediction of Outcome of Patients With Perforation Peritonitis on the Basis of Apache-Ii Scoring System

Peritonitis is the inflammation of the peritoneum and is most commonly due to localized or generalized infection.It is most common surgical emergency in India.Most common causes in India are perforated gastric /duodenal ulcer.Any type of peritonitis can be very serious and life threatening if not evaluated and treated properly.Prognosis in peritonitis is decisively influenced by the health status of the patients at beginning of treatment.Accurate prediction of the outcome of the disease can initially be made on the basis of the prognostic scoring systems, currently several scoring systems are employed.The APACHE prognostic scoring system for measuring severity of illness in critically ill patients was developed in 1981 by William A Knaus 1 .APACHE -II introduced in 1985 was a simplified modification of original APACHE.APACHE -II was further refined to APACHE -III in 1991.It is important for surgeons to develop at least a rudimentary knowledge of scoring system for perforation peritonitis, as it will play an increasing role to explain the prognosis of the disease.Aims & objectives of study are to predict the outcome of the patients with perforation peritonitis on the basis of APACHE -III scoring system.This study was conducted on 72 patients, admitted to emergency ward of Rama Medical college hospital & Research centre, Mandhana Kanpur, who were diagnosed as cases of perforation peritonitis from January 2009 -January 2011.All the patients were evaluated according to APACHE -III scoring system within 24 hours of admission.All the patients admitted in emergency ward initially examined clinically then required investigations were done.Total APACHE III score range for (0-299).Patients with lower scores have more favourable prognosis than patients with higher scores.Thus it was concluded from this study that patients with low scores have favourable outcome as compared to patients with high scores.