APACHE II in emergency operations for perforated ulcers.

Most reports concerning the management of patients with perforated peptic ulcers suffer from inadequate documentation of the severity of illness and the operative risk of these patients. This study attempts to evaluate the prognostic value of the APACHE II scoring system in a homogeneous group of patients with perforated peptide ulcers, to assess it as a potential clinical and research tool for future studies, and to examine its usefulness in stratifying these patients according to their surgical risk. Our results confirm the prognostic value of the APACHE II scoring system, measured either retrospectively or prospectively, in patients who undergo emergency operations for perforated ulcers. When measured preoperatively, it accurately stratifies these patients to various risk groups and should therefore be used in future trials examining various treatment aspects of this condition. Our data, evaluating the results of various procedures in subgroups of patients stratified by the APACHE II, failed to support the superiority of one approach over another.