NEW SCALE FOR COMORBIDITY ASSESSMENT IN EMERGENCY ABDOMINAL SURGERY

Such scales applied to other branches are used for comorbidity assessing (Cmb) in emergency abdominal surgery and disease management as well. These scales do not have pathogenetic reasoning, and do not achieve the desired goal. Aim of the study. To develop a scale for assessing Cmb in emergency abdominal surgery. Materials and methods. 499 patients with acute ab-dominal surgical pathology. 210 patients had acute peritonitis (АР). 409 patients had accompanying diseases. The following data was analysed: age, surgical and accompanying diseases, postoperative complications (POC), and severity of АР by І. Iu. Polianskiy, Mannheim Peritonitis Index. In order to differentiate Cmb classes a scale has been developed. The scale comprises the parameters of both primary and accompanying diseases, АР and age. Each item corresponds to a certain number of points. Influence factors were determined with the help of dispersion analysis. Results of the study. The amount of points statistically explains the dispersion of POC parameters. Four classes of comorbidity were highlighted according to the results of the analysis. Some prior experiments that had been carried out constituted the basis of the classification. To estimate the predic-tive impact of the scale, the dispersion analysis of the classifica-tion of РОС indexes has been made; depending on the class Cmb. Different classes are to be established to make a whole different of РОС severity patients had. Conclusions: 1. The amount of points that are determined by the scale for assessing comorbidity statistically explains the dispersion of POC parameters. 2. According to the results of dispersion analysis, it is essential to highlight four classes of Cmb, which make a com-pletely different of РОС severity. 3. Assigning patients to a specific class of Cmb makes it easy to predict the probability of complications development and to take the necessary precautions.