Majed El HechiNapaporn KongkaewpaisanMohamad El MohebBrittany AicherJose DiazLindsay OʼMearaCassandra DeckerJennifer RodriquezThomas SchroeppelRishi RattanGeorgia VasileiouD. Dante YehUrsula SimonoskDavid TurayDaniel CullinaneCory EmmertMarta McCrumNatalie WallJeremy BadachAnna Goldenberg-SandaHeather CarmichaelCatherine VelopulosRachel ChoronJoseph SakranKhaldoun BekdacheGeorge BlackThomas ShoultzZachary ChadnickVasiliy SimFiras MadbakDaniel SteadmanMaraya CamazineMartin ZielinskiClaire HardmanMbaga WalusimbiMirhee KimSimon RodierVasileios PapadopoulosGeorgios TsoulfasJavier PerezHaytham KaafaraniSiriraj HospitalLoma Linda University Medical CenterMassachusetts General HospitalMarshfield ClinicUniversity of Colorado Anschutz Medical CampusUT Southwestern Medical CenterEastern Maine Medical CenterThe University of UtahNYU Grossman School of MedicineUniversity of Miami Leonard M. Miller School of MedicineMemorial Hospital CentralStaten Island University HospitalCooper University HospitalHackensack University Medical CenterPapageorgiou General HospitalUniversity of Maryland R Adams Cowley Shock Trauma CenterMiami Valley HospitalUniversity of Florida College of MedicineMayo ClinicJohns Hopkins School of Medicine2022-08-042022-08-042021-05-01American Journal of Surgery. Vol.221, No.5 (2021), 1069-107518791883000296102-s2.0-85090481391https://repository.li.mahidol.ac.th/handle/20.500.14594/78275Introduction: We sought to evaluate whether the Emergency Surgery Score (ESS) can accurately predict outcomes in elderly patients undergoing emergent laparotomy (EL). Methods: This is a post-hoc analysis of an EAST multicenter study. Between April 2018 and June 2019, all adult patients undergoing EL in 19 participating hospitals were prospectively enrolled, and ESS was calculated for each patient. Using the c-statistic, the correlation between ESS and mortality, morbidity, and need for ICU admission was assessed in three patient age cohorts (65–74, 75–84, ≥85 years old). Results: 715 patients were included, of which 52% were 65–74, 34% were 75–84, and 14% were ≥85 years old; 51% were female, and 77% were white. ESS strongly correlated with postoperative mortality (c-statistic:0.81). Mortality gradually increased from 0% to 20%–60% at ESS of 2, 10 and 16 points, respectively. ESS predicted mortality, morbidity, and need for ICU best in patients 65–74 years old (c-statistic:0.81, 0.75, 0.83 respectively), but its performance significantly decreased in patients ≥85 years (c-statistic:0.72, 0.64, 0.67 respectively). Conclusion: ESS is an accurate predictor of outcome in the elderly EL patient 65–85 years old, but its performance decreases for patients ≥85. Consideration should be given to modify ESS to better predict outcomes in the very elderly patient population.Mahidol UniversityMedicineArticleSCOPUS10.1016/j.amjsurg.2020.08.039