Publication Misdemeanour

This retrospective study examined the prognostic value of the APACHE II scoring system in patients undergoing emergency operations for bleeding peptic ulcer. Between 1980–1997 there were 228 patients who had operated emergency for bleeding peptic ulcer. There were 57 operations (25%) for gastric ulcers and 171 (75%) for duodenal ulcers. There were 48 (21.2%) female, 180 (78.9%) male and the median age was 46.0 B 16.4 (range 15–81). In the group who had operated for gastric ulcer male/female ratio was 47/10 and the median age was 49.4 B 16.4. In the group who had operated for duodenal ulcer male/female ratio was 133/38 and the median age was 44.8 B 16.3. The mean APACHE II scores in survivors and in patients who died were 5.29 and 9.27 respectively. In patients who had high APACHE II scores, vagotomy + drainage procedures carried less risk of mortality than vagotomy + resection. If used in daily practice it may assist the surgeon in stratifying patients into a low-risk group in which major operations are well tolerated and outcome is favourable and high-risk group in which the risk of mortality is high and the performance of procedures of lesser magnitude is probably more likely to improve survival.