Comparative Analysis of APACHE II and P-POSSUM

External Causes of Morbidity and Mortality Clinical Trial

Official title:

Comparative Analysis of APACHE II and P-POSSUM Scoring Systems in Predicting Postoperative Mortality in Patients Undergoing Emergency Laparotomy

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02471612
• Other study ID #: 201-26104-132-108296
• Status: Completed
• Start date: December 2013
• Est. completion date: December 2014

Study information

• Verified date: May 2016
• Source: Tata Main Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

To compare APACHE II and P-POSSUM scoring system in emergency laparotomy.

Description:

To compare APACHE II and P-POSSUM scoring system in predicting postoperative mortality in patients undergoing emergency laparotomy.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 159
• Est. completion date: December 2014
• Est. primary completion date: November 2014
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• All patients above 18 years of age undergoing emergency laparotomy at Tata Main Hospital form 01st December 2013 to 30th November 2014 will be included in the study.

Exclusion Criteria:

• Patients willingly seeking referral to a different hospital

Related Conditions & MeSH terms

• External Causes of Morbidity and Mortality

Locations

Country	Name	City	State
India	Tata Main Hospital	Jamshedpur	Jharkhand

Sponsors (1)

Lead Sponsor	Collaborator
Tata Main Hospital

Country where clinical trial is conducted

India, 

References & Publications (1)

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 Aug 26;7(1 — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Area Under the Receiver Operating Curve (ROC) as a Measure of the Accuracy of the APACHE II and P-POSSUM Scoring Systems to Predict Mortality	Participants will be followed for the duration of hospital stay (expected average of 30 days) and mortality was noted.All patients undergoing emergency laparotomy at Tata Main Hospital form 01st December 2013 to 30th November 2014 were included in the study. All patients were scored with APACHE II and P-POSSUM scoring systems on the day of surgery. Area under the curve (AUC) is used to measure the "size" of the prediction composed by the graphic display between the 'sensitivity' and the '1-specificity' relationship. AUC can range from 0.5 to 1.0 and a result of 1.0 indicates a perfect discriminatory ability. An AUC value > 0.8 is considered good, a range between 0.60-0.80 is considered as moderate, and an AUC value < 0.60 is regarded as poor. For APACHE-II, a cut off score of >/=24 was determined; for P-POSSUM, a cut off score of >/= 63 was determined.	30 days
Secondary	Length of Stay (LOS)	The mean duration of hospital stay or Length of Stay was recorded	30 days
Secondary	Need for Postoperative Ventilator Support	Number of patients needing post-operative ventilatory support	30 days
Secondary	Need for Post Operative Inotropic Support	Number of patients needing post-operative inotropic support	30 days
Secondary	Cardiac Morbidity (AMI or Arrhythmias Needing Treatment)	Number of patients noted to have Cardiac morbidity: Acute myocardial infarction (AMI) or arrhythmias needing treatment	30 days
Secondary	Number of Participants With Acute Kidney Injury (AKI)	Acute Kidney Injury (AKI) was diagnosed based on the Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group (2012) guidelines; Increase in Serum Creatinine (S. Cr) by =0.3 mg/dl (= 26.5 µmol/l) within 48 hours; OR; Increase in S. Cr to =1.5 times baseline, which is known or presumed to have occurred within prior 7 days; OR; Urine volume <0.5 ml/kg/h for 6 hours	30 days
Secondary	Patients Needing Re-exploration	Number of patients needing return to the operation theater for surgery for the same pathology or any other complication arising out of the initial surgery	30 days

External Links

•   Comparative analysis of APACHE-II and P-POSSUM scoring systems in predicting postoperative mortality in patients undergoing emergency laparotomy