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INTRODUCTION
Acute generalized peritonitis from typhoid ileal perforation is a potentially life-threatening condition. It is a common surgical emergency in many general surgical units in the developing countries and it is often associated with high morbidity and mortality.[1],[2] Grading the severity of acute peritonitis has assisted in no small way in decision-making and has improved therapy in the management of severely ill patients.[3] The ability to objectively estimate patients' risk for mortality or other important outcome is an important part of managing severely ill patients.[4] Empirically based risk assessment for important clinical events has been extremely useful in evaluating new therapies, in monitoring resources utilization and improving the quality of care.[5],[6] Scoring systems had been found useful in predicting the outcome in critically ill patients, thus allowing application of resources for effective use.[7] The introduction of Injury Severity Score by Bakers et al in 1974[8] and Abbreviated Injury Scale in 1981[9] successfully opened avenues for further development of severity grading systems. Many scoring systems have been designed and used successfully to grade the severity of acute peritonitis and intra-abdominal sepsis.[15],[9],[10]
The most widely used index, APACHE II (Acute Physiological and Chronic ill Health Evaluation), was developed from a mixed group of medical and surgical patients.[5] Although not specifically designed for general surgical practice it has been successfully used by many authors to assess critically ill general surgical patients.[11],[12],[13],[14],[15],[16] It has also been compared with other scoring systems with good results.[12]
The aim of this study was to grade the severity of acute generalized peritonitis from typhoid ileal perforation using modified APACHE II score. This study was carried out at the Wesley Guild Hospital, Ilesa, a unit of Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. The hospital, in its about a century of existence, has catered to the health needs of the largely agrarian rural and semi-urban community of Ijesas and Ekitis in the Osun and Ekiti States in Western Nigeria. It is hoped that this study will serve as the basis for further study in the area of severity assessment of generalized peritonitis from typhoid ileal perforation in centres similar to ours.
PATIENTS AND METHODS
A prospective survey of patients with acute generalized peritonitis due to typhoid ileal perforation was carried out at...