Feasibility study of APACHEⅡ score to assess the patients with hemorrhagic shock before operation

doi:10.3969/j.issn.1002-1949.2015.03.012

Abstract：Objective To observe the feasibility of APACHEⅡscore on preoperative evaluation of emergency surgery in patients with hemorrhagic shock.Methods Sixty cases of patients with hemorrhagic shock who were undergone emergency surgery from October 2013 to June 2014 were enrolled in this study, and were divided into Group L (0~9 points) and Group H (≥10 points) according to the preoperative APACHEⅡscore.Heart rate ( HR) , arterial blood pressure ( ABP) , body temperature ( T) and hemoglobin ( Hb) level were recorded respectively at hospitalization ( T0 ) , before anesthesia ( T1 ) and before leaving the operating room ( T2 );anesthesia time, operation time, intraoperative fluid infusion, intraoperative fluid infusion and estimated blood loss, etc.were also recorded.Results Six cases were excluded.A total of 54 cases were included in the data analysis.At T0 and T1 , HR was higher in Group H than Group L, while SBP, DBP, and T were lower in Group L ( P<0.01 or P<0.05).At T0, no statistical difference was found in term of Hb between the groups, however, Hb was significantly lower in Group H compared with Group L at T1(P<0.01).Intraoperative blood transfusion were compared.Perioperative autologous blood correction and heterogenous RBC amount were larger in Group H than Group L.Heterogenous blood infusion rate was higher than Group L.Total amount of RBC and estimated blood loss were significantly higher than Group L (P<0.01 or P<0.05).Conclusion APACHEⅡscore is feasible to evaluate patients with hemorrhagic shock before emergency surgery.It is of strong clinical guiding significance and clinical research potential, which is worth promoting.