The validity of emergency surgery score in predicting mortality and complications in general surgical emergencies. | ||
| The Egyptian Journal of Surgery | ||
| Volume 43, Issue 4, October 2024, Pages 1258-1267 PDF (490.04 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/EJSUR.2024.282151.1047 | ||
| Authors | ||
| Rimon B. Rizk* ; Khaled Shawky | ||
| Department of General Surgery, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt | ||
| Abstract | ||
| Background: Patients who need emergency general surgery (EGS) face an increase in 30-day mortality and complication rates that can be anticipated by emergency surgery score (ESS). Aim: The study aimed to measure the validity and efficacy of ESS application on EGS patients admitted at Beni-Suef University Hospital to calculate the rates of postoperative mortality, complications, reoperation, and ICU admission. Patients and Methods: This was a retrospective validation study. The study included 200 patients (older adults and elderly) who were admitted to the general surgery ward for EGS from September 1, 2023 to March 1 2024. The primary outcome was measuring the 30-day mortality rate. However, the secondary outcomes were measuring the occurrence of at least one complication, reoperation, and ICU admission rates. Admitted comorbidities, as well as preoperative laboratory tests, were collected. Surgical outcomes were predicted for patients using ESS calculation. Postoperative outcomes were tracked from the day of surgery to 30 days. Results: Among patients admitted, total prevalence of 30-day mortality was nine (4.5%), while 30-day complications rate was 27%. There was a significant increase (P<0.001) in mortality due to the increase of ESS with an area under the curve (AUC) NELA score (0.846) and confidence interval (CI) (95% CI: 0.717–0.976), and AUC P-POSSUM score of 0.811 and CI (95% CI: 0.734–0.972) with no significant difference between the two scores (P=0.369), and AUC P-POSSUM score of 0.811 and CI (95% CI: 0.734–0.972) with no significant difference between the two scores (P=0.369). There was a significant increase (P<0.001) in the prediction of at least one complication due to the increase of ESS with an AUC NELA score (0.919) and CI (95% CI: 0.88–0.957) and AUC P-POSSUM score (0.927) and CI (95% CI: 0.82–0.945), with no significant difference between the two scores (P=0.269). There was a significant increase in ICU readmission due to the increase of ESS (P<0.001) with an AUC (0.785) and CI (95% CI: 0.678–0.892). Conclusion: ESS is a golden key in predicting mortality, complications, and ICU admission among elderly patients who underwent EGS and can be used for frontline decision-making, family and patient guidance, resource allocation, and quality monitoring of elderly surgical care. | ||
| Keywords | ||
| Emergency general surgery; mortality; score | ||
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