BACKGROUND: The general objective of this work was to compare APACHE II scores referent to prognostic in the preoperative period of major and minor surgeries. Specific objectives included: (1) the evaluation of the ability of APACHE II to predict morbidity in the preoperative period; (2) the comparison of the results of both types of surgery; and (3) the comparison of the mortality rates observed and expected according to the Knaus Equation. METHODS: This was a prospective cohort study, performed in 30 months. Group 1 included 30 patients, submitted to inguinal herniorraphy, representing minor surgery. Fifty cases were included in group 2, representing major surgery: 20 were submitted to esophagectomy, 20 to gastrectomy and 10 underwent cephalic duodenopancreatectomy. RESULTS: The average preoperative score of patients in group 1 was 2.5 points (range 0 to 8 points). The APACHE II score of group 2 was in average 3.9 points, ranging from zero to 12 points (standard deviation: 2.8 points). The morbidity of the two groups, in general or as evaluated according to low, moderate or high scores, was significantly different when compared by the chi-square test (p<0.00001). General mortality and high scores, as evaluated by the Yates-corrected chi-square test, were different between the two groups (p<0.001 and p<0.0005). When the mortality rate was classified according to the score of points, no statistically significant differences were observed between low and moderate scores. CONCLUSION: The APACHE II score, when applied during the preoperative period. showed the power to predict the outcome of patients submitted to major surgeries. High morbidity and mortality rates are associated to patients presenting APACHE II scores higher than eight, particularly if submitted to major surgery.
APACHE; Prognosis; Preoperative care; Postoperative complications
