RISK FACTORS IN DUODENAL ULCER PERFORATIONS: APACHE II AND MANNHEIM INDEXES IN PROGNOSTICS
FERDA KÖKSOY, GÜRSEL SOYBİR, DİLER ÖZAÇMAK, ORHAN YALÇIN, YALÇIN AKER
SB Taksim Hastanesi, 1.Genel Cerrahi Kliniği/İSTANBUL
Abstract
103 cases which were operated during 1984-1989 and possessed the criteria we wanted were included into this study. In respect with the risk factors 66 cases which were operated during 1984-1987 were evaluated retrospectively and 37 cases during 1988-1989 prospectively in accordance with APACHE II index and 83 cases during 1984-88 retrospectively while 20 cases which belong to 1989 were evaluated with MANNHEIM index. Simple suture was applied to 28 cases (27.2%) and definitive operation was applied to 75 cases (%72.8).
The meaningful relation between early complication development rate and old age, long perforation period, concurrent medical diseases, sepsis, gross peritoneal contamination and type of the operation chosen were found to be significant. The mortality rate showed significant correlations with old age, preoperative shock, sepsis, concurrent medical diseases, and long perforation period.
The mortality rate and the rate of early complication development were found to be significantly high in those cases that had an APACHE II score more than 10 and a MANNHEIM score more than 25. After an average of 3.1 year follow up the VISICK I-II group was found to be 80.4% in the series, with a mortality rate of 5.8% (6 cases)