경희대학교
의과대학 외과학교실
김영혁·이석환·고영관·고석환·홍생화·윤
충, 주흥재
Analysis
of Surgical Mortality
Young
Hyug Kim, M.D., Seok Hwan Lee, M.D., Young
Gwan Ko, M.D. , Suck Hwan Koh, M.D.,
Sung Wha Hong, M.D., Choong
Yoon, M.D. , Hoong Zae Joo, M.D.
Department
of Surgery, College of Medicine, Kyung Hee University. Seoul. Korea
Background
= The results of surgical mortality are especially difficult to evaluate because
groups of diseases concerned not compatible, the methods of treatment differ, and
there are no universally valid definitions and criteria. In the past, efforts have
been made to devise scoring system, each intended to predict with greater accuracy
the outcome of the illness from The begining of treatment. The goal of this study
was to review The outcome of surgical mortality, and to assess the correlation between
APACHE II score and the American Society of Anesthesiologist(ASA) class.
Materials
and Methods : We reviewed 112 patients died within 60 days after thc initial operation
from Jan. 1987 1o July 1998. All patients were classified preoperatively into 6
cate-cories in accordance with the recommendations of ASA. The APACHE II scores
were calculated in 91 patients among these patients. The worse physiologic values
during the first 24 hours after the admission were used for the calculation. All
statistical analyses were performed with Wilcoxon rank sums test and Spearman correlation
test using SPSS software.
Results
: The overall surgical mortality was 0.57% The APACHE II scores of defined patients
ranged from 4 to 33 and the median score was 16 point. A significant correlation
was noted between APACHE II and ASA class (Spearman correlation test p=0.004). The
survival days were shortened in the patients who had higher ASA class. The survival
days of ASA II was 19.6±18.4 (mean±standard deviation), ASA III was 15.9±16.2,ASA
IV was 10.5±12.4, and ASA V was 1.4±0.9. The median APACHE II score associated
with emergency operation was significantly higher compared with the elective operation.
Conclusion
: The relationship between the APACHE II scores and ASA class was linear and significantly
correlated. The APACHE II and ASA class can provide Io estimate objectively patient
risk for mortality.
Key
Words : Surgical mortality, APACHE II score, ASA class |
