Study of the Therapeutic Plan Based on the APACHE Score as a Prognostic Factor for Perforated Colorectal Cancer

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 33; no. 6; pp. 947 - 952
• Main Authors: Sakamoto, Kazuhiro, Hirata, Fumiko, Matsudaira, Shinichi, Maekawa, Hiroshi, Sakurada, Mutsumi, Mizuguchi, Konomi, Sugimoto, Kiichi, Sato, Koichi, Niwa, Koichiro
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society for Abdominal Emergency Medicine 30.09.2013; 日本腹部救急医学会
• Subjects: APACHE IIスコア; 大腸癌; 敗血症; 消化管穿孔
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem.33.947

Objectives: We examined the prognostic factors and therapeutic plan for perforated colorectal cancer by investigating the postoperative outcomes. Methods: The subjects were 49 patients with perforated colorectal cancer who underwent surgery. Results: Twelve patients (24.5%) died because of sepsis after surgery. In nonsurvivors when compared to survivors, there were significantly more patients found with high values of the Acute Physiology and Chronic Health Evaluation (APACHE) II score (p=0.04). When the patients were divided into 2 groups: the patients with APACHE II scores of 17 or less and those with APACHE II scores of 18 or more, the mortality rates of the patients with APACHE II scores of 17 or less and 18 or more were 16.7% and 71.4% respectively, and there was a significant difference in the mortality between the two groups (p=0.007). Among the patients with APACHE II scores of 17 or less and the curability A, B who underwent resection of the primary lesion, the mortality was 6.7%. Conclusion: The APACHE II score is useful as a prognostic factor in patients with perforated colorectal cancer. It is suggested that the curative resection with resection of the primary lesion is permissible among the patients with APACHE II scores of 17 or less because of the low mortality rate.