APACHE II Scoring in Surgical Upper Gastrointestinal Emergencies

Schein, Moshe; D'Egidio, A

doi:10.1159/000171301

Cited by 5 publications

(5 citation statements)

References 20 publications

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“…Furthermore, no significant changes were observed between surgically treated patients for the two time periods evaluated, except that patients operated during the earlier time period more commonly failed to demonstrate SRH than did patients operated more recently. The mortality rates did corroborate previously published data correlating APACHE II scores with hospital mortality among patients admit-ted to intensive care units for diseases of all types and for GI bleeding in particular [9,14].…”

Section: Discussionsupporting

confidence: 87%

“…Optimal management of gastrointestinal bleeding requires early endoscopy to identify and localize the bleeding lesion, a centralized GI bleeding service with close cooperation between gastroenterologists and GI surgeons, a well defined protocol for patient management, and clear unequivocal endpoints for surgical intervention. Consistently low mortality for ulcer bleeding has been reported from units with such policy, irrespective of whether therapeutic endoscopy is practiced or a threshold for surgical intervention [8,9]. The use of therapeutic endoscopy as the first line treatment of ulcer bleeding also requires major philosophical as well as logistic changes in the hospital if such a policy is to make a real impact.…”

Section: Invited Commentarymentioning

confidence: 99%

“…ulcers had declined in recent years, the number of emergent surgical procedures had appeared to increase, particularly in the geriatric population [1,3,[5][6][7][8]. This assessment warrants concern, as patients over the age of 65 tolerate physiologic insults associated with upper GI bleeding less well than younger individuals [3,4,9].…”

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confidence: 99%

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Impact of therapeutic endoscopy on the treatment of bleeding duodenal ulcers: 1980–1990

et al. 1995

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Therapeutic endoscopy (TE) has provided a new means for treating peptic ulcer disease, prompting a reevaluation of surgery's role. The aim of this study was to determine if surgical therapy of bleeding duodenal ulcers has changed since the advent of TE. This retrospective review involved consecutive time periods during which TE was (1985-1990) and was not (1980-1984) widely available. Exclusion criteria were prior gastric surgery, nonpeptic conditions, and untreated ulcers. Inclusion standards were met by 252 patients (180 men, 72 women) whose mean age was 67 years. Patients were grouped by the initial therapeutic intervention. Groups were similar in age, medical condition (mean APACHE II score 16), and morbidity. Seventy-five patients had surgery alone during 1980-1984 and 38 during 1985-1990. TE was initially performed on 134 patients during 1985-1990. Bleeding (n = 30) and perforation (n = 1) prompted emergent operation in 23% of cases following TE. Thus 69 (38 + 31) patients underwent surgery between 1985 and 1990. Preprocedure transfusions averaged 4.1 units in the endoscopic group and 8.2 units in the operative groups (p < 0.0001). Disagreement existed between the endoscopic and surgical descriptions of ulcer location in 53% of cases. Emergent surgery was required in 45% of hemodynamically unstable patients versus 14% of stable patients who initially underwent TE (p < 0.0001). Sixty-one percent of incompletely visualized TE-treated lesions required operation, and 18% of well visualized ulcers underwent operation (p < 0.0001). Hospital mortality was similar (8% versus 16%) in the endoscopic and operated groups (p = 0.7). Mean follow-up was 540 days.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionsupporting

confidence: 87%

Section: Invited Commentarymentioning

confidence: 99%

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Impact of therapeutic endoscopy on the treatment of bleeding duodenal ulcers: 1980–1990

et al. 1995

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“…The study concluded that preoperative resuscitation was beneficial, could be appropriately audited and that patients who deteriorated might have benefited from more urgent surgery. Illness severity scoring systems have been used for perioperative risk stratification with single preoperative scores and serial postoperative scoring33–36. However, sequential scoring models to study the physiological response during the resuscitation of patients with intra‐abdominal emergencies have not been described previously.…”

Section: Discussionmentioning

confidence: 99%

Sequential physiology scoring facilitates objective assessment of resuscitation in patients with an intra-abdominal emergency

O'Dair

Leaper

2003

British Journal of Surgery

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“…The score has been sought to be validated in abdominal surgery in general [17], peritonitis in general [18], and PPU [11,19].…”

Section: Introductionmentioning

confidence: 99%

Accuracy of clinical prediction rules in peptic ulcer perforation: an observational study

Buck

Vester‐Andersen

Møller

2011

Scandinavian Journal of Gastroenterology

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APACHE II Scoring in Surgical Upper Gastrointestinal Emergencies

Cited by 5 publications

References 20 publications

Impact of therapeutic endoscopy on the treatment of bleeding duodenal ulcers: 1980–1990

Impact of therapeutic endoscopy on the treatment of bleeding duodenal ulcers: 1980–1990

Sequential physiology scoring facilitates objective assessment of resuscitation in patients with an intra-abdominal emergency

Accuracy of clinical prediction rules in peptic ulcer perforation: an observational study

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