To the Editor.—I read with interest the recent article by Bohnen et al1 that represents the first published prospective effort to validate the pretreatment APACHE II score in abdominal sepsis.
During the past 18 months we have been conducting a prospective study examining the value of intraoperative peritoneal lavage with saline solution and antibiotics in the treatment of abdominal infections. The APACHE II score is prospectively measured in all patients in an attempt to facilitate their stratification. All patients admitted to the study are treated by one surgeon in one surgical unit. All variables of the APACHE II score are measured before operation and entered on a study data sheet. The score is calculated by one observer (M.S.). Only patients undergoing formal laparotomy are considered; appendiceal infections are included only if the patient requires a midline laparotomy. Patients with diffuse peritonitis from colonic sources or from operative complications