Background: The most prevalent cause of peritonitis, which is an inflammation of the peritoneum, is a localized or widespread infection. In India, this is the most frequent surgical emergency. In India, perforated stomach or duodenal ulcers are the most frequent causes. If not properly diagnosed and treated, peritonitis of any kind can be extremely dangerous and even fatal. An important factor in the prognosis of peritonitis is the patient’s state of health at the start of treatment. Numerous prognostic scoring systems are currently in use, and they can be used to initially make accurate predictions about the course of the disease. The purpose of the study is to use the APACHE – III scoring method to predict the prognosis of patients with perforated peritonitis. Methods: This study was carried out on 72 patients who were diagnosed with perforation peritonitis between December 2017 and November 2018 and were hospitalized to the emergency ward (general surgery) of Darbhanga Medical College and Hospital, Laheriasarai, Bihar. Within 24 hours of their hospitalization, all patients had evaluations using the APACHE – III grading system. Every patient brought to the emergency room had a clinical examination before any necessary investigations were carried out. Range of total scores for APACHE III (0-299). Results: Majority of survivors belong to age group 20- 60 yrs. In this series, male patients were 55 (76%) and female patients were 17 (23%). Mortality was higher in females (23.5%) as compared to male (7.2%). Most common cause of perforation peritonitis was gastric/duodenal perforations (55%) followed by small bowel perforations (20%), blunt abdominal trauma (11%), appendicular perforation (4%), colon perforation (2.7%), gall bladder perforation (2.7%), stab injury abdomen (1.3%) and firearm injury abdomen (1.3%). Most of the patients (72%) were managed with primary repair of perforations. Mean duration of hospital stay is 13 days. Major causes of postoperative complications were wound infection (25%), wound dehiscence (15%), septicemia (8%) and faecal fistula (2.7%). Patients with lower scores have more favourable prognosis than patients with higher score. Observed mortality rate was 41.6% in the group with APACHE –III score of >60, which was comparable to predicted mortality of 42.6%. Conclusion: The prognosis for patients with lower scores is better than that of those with higher scores. Thus, the study’s conclusion was that patients with lower scores fare better than those with higher scores.

Background: The most prevalent cause of peritonitis, which is an inflammation of the peritoneum, is a localized or widespread infection. In India, this is the most frequent surgical emergency. In India, perforated stomach or duodenal ulcers are the most frequent causes. If not properly diagnosed and treated, peritonitis of any kind can be extremely dangerous and even fatal. An important factor in the prognosis of peritonitis is the patient’s state of health at the start of treatment. Numerous prognostic scoring systems are currently in use, and they can be used to initially make accurate predictions about the course of the disease. The purpose of the study is to use the APACHE – III scoring method to predict the prognosis of patients with perforated peritonitis. Methods: This study was carried out on 72 patients who were diagnosed with perforation peritonitis between December 2017 and November 2018 and were hospitalized to the emergency ward (general surgery) of Darbhanga Medical College and Hospital, Laheriasarai, Bihar. Within 24 hours of their hospitalization, all patients had evaluations using the APACHE – III grading system. Every patient brought to the emergency room had a clinical examination before any necessary investigations were carried out. Range of total scores for APACHE III (0-299). Results: Majority of survivors belong to age group 20- 60 yrs. In this series, male patients were 55 (76%) and female patients were 17 (23%). Mortality was higher in females (23.5%) as compared to male (7.2%). Most common cause of perforation peritonitis was gastric/duodenal perforations (55%) followed by small bowel perforations (20%), blunt abdominal trauma (11%), appendicular perforation (4%), colon perforation (2.7%), gall bladder perforation (2.7%), stab injury abdomen (1.3%) and firearm injury abdomen (1.3%). Most of the patients (72%) were managed with primary repair of perforations. Mean duration of hospital stay is 13 days. Major causes of postoperative complications were wound infection (25%), wound dehiscence (15%), septicemia (8%) and faecal fistula (2.7%). Patients with lower scores have more favourable prognosis than patients with higher score. Observed mortality rate was 41.6% in the group with APACHE –III score of >60, which was comparable to predicted mortality of 42.6%. Conclusion: The prognosis for patients with lower scores is better than that of those with higher scores. Thus, the study’s conclusion was that patients with lower scores fare better than those with higher scores.