Severity Scoring Systems Use In Surgery: An Experimental Update

Abstract

By means of experimental modeling in acute model of abdominal sepsis, the efficacy of using of individual scoring systems for estimating the severity of surgical patients’ state (APACHE, APACHE II, MIP) has been studied in a comparative aspect. The prognostic value and the effectiveness of scoring pathologic conditions was studied by simulating an acute pathological process in experiment. The object of the study were 19 inbreed dogs weighing 8-15 kg (12.39±1.47 kg). To assess the functional state changes of the organism we determined heart rate, respiratory rate, arterial blood oxygenation indices, arterial blood pH, ionogramme indicators, hematocrit, creatinine, peripheral blood WBC count and formula, conducted a macroscopic assessment of the pathological process development. It was found that application of such systems with a prognostic purpose is advisable for using under clinical conditions. However, several factors are missing in all of the single scores. This lead to inaccurate data obtained when using only one separate system for the prognostic purpose. Thus, it is expedient to combine different evaluation systems with the aim of enhancing prognostic reliability and optimizing the treatment tactics. The combined use of several scoring system in each particular case provide efficiency and accuracy in prognosis of the patients' outcome.