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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/58117
Title: Prospective validation of the Emergency Surgery Score in emergency general surgery: An Eastern Association for the Surgery of Trauma multicenter study
Authors: Haytham M.A. Kaafarani
Napaporn Kongkaewpaisan
Brittany O. Aicher
Jose J. Diaz
Lindsay B. O'Meara
Cassandra Decker
Jennifer Rodriquez
Thomas Schroeppel
Rishi Rattan
Georgia Vasileiou
D. Dante Yeh
Ursula J. Simonoski
David Turay
Daniel C. Cullinane
Cory B. Emmert
Marta L. McCrum
Natalie Wall
Jeremy Badach
Anna Goldenberg-Sandau
Heather Carmichael
Catherine Velopulos
Rachel Choron
Joseph V. Sakran
Khaldoun Bekdache
George Black
Thomas Shoultz
Zachary Chadnick
Vasiliy Sim
Firas Madbak
Daniel Steadman
Maraya Camazine
Martin D. Zielinski
Claire Hardman
Mbaga Walusimbi
Mirhee Kim
Simon Rodier
Vasileios N. Papadopoulos
Georgios Tsoulfas
Javier Martin Perez
George C. Velmahos
Loma Linda University Medical Center
Massachusetts General Hospital
Marshfield Clinic
University of Colorado at Denver Anschutz Medical Campus
UT Southwestern Medical Center
Eastern Maine Medical Center
The University of Utah
NYU Grossman School of Medicine
Memorial Hospital Central
Staten Island University Hospital
Cooper University Hospital
Hackensack University Medical Center
Aristotle University of Thessaloniki
University of Maryland R Adams Cowley Shock Trauma Center
Faculty of Medicine, Siriraj Hospital, Mahidol University
Miami Valley Hospital
University of Florida College of Medicine
Mayo Clinic
Jackson Memorial Hospital
Harvard Medical School
Johns Hopkins School of Medicine
Keywords: Medicine
Issue Date: 1-Jul-2020
Citation: Journal of Trauma and Acute Care Surgery. Vol.89, No.1 (2020), 118-124
Abstract: Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. BACKGROUND The Emergency Surgery Score (ESS) was recently developed and retrospectively validated as an accurate mortality risk calculator for emergency general surgery. We sought to prospectively validate ESS, specifically in the high-risk nontrauma emergency laparotomy (EL) patient. METHODS This is an Eastern Association for the Surgery of Trauma multicenter prospective observational study. Between April 2018 and June 2019, 19 centers enrolled all adults (aged >18 years) undergoing EL. Preoperative, intraoperative, and postoperative variables were prospectively and systematically collected. Emergency Surgery Score was calculated for each patient and validated using c-statistic methodology by correlating it with three postoperative outcomes: (1) 30-day mortality, (2) 30-day complications (e.g., respiratory/renal failure, infection), and (3) postoperative intensive care unit (ICU) admission. RESULTS A total of 1,649 patients were included. The mean age was 60.5 years, 50.3% were female, and 71.4% were white. The mean ESS was 6, and the most common indication for EL was hollow viscus perforation. The 30-day mortality and complication rates were 14.8% and 53.3%; 57.0% of patients required ICU admission. Emergency Surgery Score gradually and accurately predicted 30-day mortality; 3.5%, 50.0%, and 85.7% of patients with ESS of 3, 12, and 17 died after surgery, respectively, with a c-statistic of 0.84. Similarly, ESS gradually and accurately predicted complications; 21.0%, 57.1%, and 88.9% of patients with ESS of 1, 6, and 13 developed postoperative complications, with a c-statistic of 0.74. Emergency Surgery Score also accurately predicted which patients required intensive care unit admission (c-statistic, 0.80). CONCLUSION This is the first prospective multicenter study to validate ESS as an accurate predictor of outcome in the EL patient. Emergency Surgery Score can prove useful for (1) perioperative patient and family counseling, (2) triaging patients to the intensive care unit, and (3) benchmarking the quality of emergency general surgery care. LEVEL OF EVIDENCE Prognostic study, level III.
URI: http://repository.li.mahidol.ac.th/dspace/handle/123456789/58117
metadata.dc.identifier.url: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85079847380&origin=inward
ISSN: 21630763
21630755
Appears in Collections:Scopus 2020

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