APACHE II score in massive upper gastrointestinal haemorrhage from peptic ulcer: Prognotic value and potential clinical applications

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Abstract
This study examined the prognostic value of the APACHE II scoring system in patients undergoing emergency operations for bleeding peptic ulcer. There were 96 operations for gastric ulcers and 58 for duodenal ulcers. The mean scores in survivors and in patients who died were 10.8 and 17.5 respectively. None of the 66 patients with a n APACHE II score < 11 died, whiel the mortality rate in those scored > 10 was 22 per cent. In patients scored > 10 non-resective procedures carried less risk of mortality than gastectomy. The APACHE II score is useful when measuring the severity of the acute disease and predicting the outcome in these patients. If used in daily practice it may assist the surgeon in stratifying patients into a low-risk group (score < 11) in which major operations are well tolerated and outcome is favourable and a high-risk group (scor < 10) in which the risk of mortality is high and the performance of procedures of lesser magnitude isprobably more likely to improve survival.