To compare APACHE II and P-POSSUM scoring system in emergency laparotomy.
To compare APACHE II and P-POSSUM scoring system in predicting postoperative mortality in patients undergoing emergency laparotomy.
Study Type
OBSERVATIONAL
Enrollment
159
Tata Main Hospital
Jamshedpur, Jharkhand, India
Area Under the Receiver Operating Curve (ROC) as a Measure of the Accuracy of the APACHE II and P-POSSUM Scoring Systems to Predict Mortality
Participants will be followed for the duration of hospital stay (expected average of 30 days) and mortality was noted.All patients undergoing emergency laparotomy at Tata Main Hospital form 01st December 2013 to 30th November 2014 were included in the study. All patients were scored with APACHE II and P-POSSUM scoring systems on the day of surgery. Area under the curve (AUC) is used to measure the "size" of the prediction composed by the graphic display between the 'sensitivity' and the '1-specificity' relationship. AUC can range from 0.5 to 1.0 and a result of 1.0 indicates a perfect discriminatory ability. An AUC value \> 0.8 is considered good, a range between 0.60-0.80 is considered as moderate, and an AUC value \< 0.60 is regarded as poor. For APACHE-II, a cut off score of \>/=24 was determined; for P-POSSUM, a cut off score of \>/= 63 was determined.
Time frame: 30 days
Length of Stay (LOS)
The mean duration of hospital stay or Length of Stay was recorded
Time frame: 30 days
Need for Postoperative Ventilator Support
Number of patients needing post-operative ventilatory support
Time frame: 30 days
Need for Post Operative Inotropic Support
Number of patients needing post-operative inotropic support
Time frame: 30 days
Cardiac Morbidity (AMI or Arrhythmias Needing Treatment)
Number of patients noted to have Cardiac morbidity: Acute myocardial infarction (AMI) or arrhythmias needing treatment
Time frame: 30 days
Number of Participants With Acute Kidney Injury (AKI)
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Acute Kidney Injury (AKI) was diagnosed based on the Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group (2012) guidelines 1. Increase in Serum Creatinine (S. Cr) by ≥0.3 mg/dl (≥ 26.5 μmol/l) within 48 hours; OR 2. Increase in S. Cr to ≥1.5 times baseline, which is known or presumed to have occurred within prior 7 days; OR 3. Urine volume \<0.5 ml/kg/h for 6 hours
Time frame: 30 days
Patients Needing Re-exploration
Number of patients needing return to the operation theater for surgery for the same pathology or any other complication arising out of the initial surgery
Time frame: 30 days