Nag DS, Dembla A, Mahanty PR, Kant S, Chatterjee A, Samaddar DP, Chugh P. Comparative analysis of APACHE-II and P-POSSUM scoring systems in predicting postoperative mortality in patients undergoing emergency laparotomy. World J Clin Cases 2019; 7(16): 2227-2237 [PMID: 31531317 DOI: 10.12998/wjcc.v7.i16.2227]
Corresponding Author of This Article
Deb Sanjay Nag, MBBS, MD (Gold Medalist), Senior Consultant, Department of Anaesthesiology, Tata Main Hospital, C Road West, Northern Town, Jamshedpur 831001, India. ds.nag@tatasteel.com
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Clinical Trials Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Deb Sanjay Nag, Pratap Rudra Mahanty, Shashi Kant, Abhishek Chatterjee, Devi Prasad Samaddar, Department of Anaesthesiology and Critical Care, Tata Main Hospital, Jamshedpur 831001, India
Ankur Dembla, Department of Anaesthesiology and Critical Care, Darya Ram Hospital, Sonipat 131001, India
Parul Chugh, Department of Biomedical Statistics, Sir Ganga Ram Hospital, New Delhi 110060, India
Author contributions: Nag DS, Dembla A, Mahanty PR, and Chatterjee A planned and conducted of the study, scored the patients, and prepared and edited the manuscript; Kant S and Samaddar DP prepared manuscript, reviewed the literature, and analyzed the findings; Chugh P was involved in the study as a biomedical statistician and guided the plan of the study, determined appropriate sample size, and performed statistical analysis and interpretation.
Institutional review board statement: The observational study was approved by the Hospital Ethics Committee, Tata Main Hospital.
Clinical trial registration statement: The registration identification No. NCT02471612.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Deb Sanjay Nag, MBBS, MD (Gold Medalist), Senior Consultant, Department of Anaesthesiology, Tata Main Hospital, C Road West, Northern Town, Jamshedpur 831001, India. ds.nag@tatasteel.com
Telephone: +91-943-1166582 Fax: +91-657-2224559
Received: February 22, 2019 Peer-review started: February 24, 2019 First decision: June 21, 2019 Revised: June 28, 2019 Accepted: July 20, 2019 Article in press: July 20, 2019 Published online: August 26, 2019 Processing time: 185 Days and 18.7 Hours
Core Tip
Core tip: Portsmouth modification of Physiological and operative severity for the enumeration of mortality and morbidity (P-POSSUM) and the acute physiology and chronic health evaluation II (APACHE-II) have been the most widely used scoring systems for emergency laparotomies. To date, no study with statistically significant sample size has compared them in predicting mortality in emergency laparotomies. P-POSSUM cannot be done for patients who are managed conservatively and can be scored only when histopathology reports are available. In this study, both P-POSSUM and APACHE-II were found to be equally accurate. Therefore, APACHE-II scoring system can be used as effectively as P-POSSUM with the added advantage that it can be used in the acute stratification of the patients into risk groups even before surgery.
