Value of preoperative physiologic assessment in outcome of patients undergoing major surgical procedures.

The preoperative physiologic assessment of patients undergoing elective major upper-abdominal surgery defines the operative risk in an objective manner. This assessment helps to identify patients who are at higher risk during certain types of abdominal procedures. Elderly patients with a combination of chronic diseases and physiologic derangements are at higher risk for the development of postoperative complications and operative death. The APACHE II score is an easy and objective tool that can be used preoperatively. In our study, patients with a high score (greater than or equal to 8) had the highest rate of postoperative complications (46%) and operative death (13%).