Pusajo et al developed the Abdominal Reoperation Predictive Index (ARPI) to evaluate a patient who had major abdominal surgery. This can help determine if the patient should undergo reoperation because of infectious complications. The authors are from Hospital Israelita Ezrah in Buenos Aires, Argentina.
Patient selection: recent major abdominal surgery
Parameters:
(1) timing of the original operation
(2) respiratory failure
(3) renal failure
(4) onset of ileus 72 or more hours after surgery
(5) onset of abdominal pain 48 or more hours after surgery
(6) wound infection
(7) level of consciousness
(8) onset of symptoms appearing 4 or more days after surgery
|
Parameter |
Finding |
Points |
|
timing of original surgery |
elective or urgent |
0 |
|
|
emergency |
3 |
|
respiratory failure |
absent |
0 |
|
|
present |
2 |
|
renal failure |
absent |
0 |
|
|
present |
2 |
|
ileus starting 72+ hours after surgery |
absent |
0 |
|
|
present |
4 |
|
abdominal pain starting 48+ hours after surgery |
absent |
0 |
|
|
present |
5 |
|
wound infection |
absent |
0 |
|
|
present |
8 |
|
level of consciousness |
normal |
0 |
|
|
altered (usually reduced) |
2 |
|
new symptoms starting 4+ days after surgery |
absent |
0 |
|
|
present |
6 |
where:
• The new symptoms probably reflect infectious or intra-abdominal complication.
total score = ARPI =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 32
• The higher the score the more likely reoperation will be necessary.
|
Total Score (ARPI) |
Percent of Patients Undergoing Reoperation |
|
0 to 10 |
9% |
|
11 or 12 |
40% |
|
13 or 14 |
90% |
|
15 to 32 |
100% |
where:
• A person with a very low score (0 or 2) should have a much lower rate of reoperation.
Specialty: Gastroenterology, Surgery, orthopedic, Surgery, general
