BACKGROUND: The Emergency Surgery Score (ESS) was recently validated as a scoring system to predict mortality in emergency surgery (ES) patients. We sought to examine the ability of ESS to predict the occurrence of 30-day postoperative complications in ES. METHODS: The 2011-2012 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was screened for all surgical operations classified as "emergent." Thirty-day postoperative complications were defined as per ACS-NSQIP (e.g., surgical site infection, respiratory failure, acute renal failure). Each patient-related ESS was calculated, and the correlation between ESS and the probability of occurrence of 30-day postoperative complications was assessed by calculating the c-statistic. Univariate and multivariable models were also created to identify which ESS components independently predict complications. RESULTS: Of 37,999 cases that captured all ESS variables, 14,446 (38%) resulted in at least one 30-day complication. The observed probability of a 30-day complication gradually increased from 7% to 53% to 91% at scores of 0, 7, and 15, respectively, with a c-statistic of 0.78. For ESS >15, the complication rate plateaued at a mean of 92%. On multivariable analyses, each of the 22 ESS components independently predicted the occurrence of postoperative complications. CONCLUSIONS: ESS reliably predicts postoperative complications in ES patients. Such a score could prove useful for (1) perioperative patient and family counseling and (2) benchmarking the quality of ES care. LEVEL OF EVIDENCE: Prognostic, level III.
BACKGROUND: The Emergency Surgery Score (ESS) was recently validated as a scoring system to predict mortality in emergency surgery (ES) patients. We sought to examine the ability of ESS to predict the occurrence of 30-day postoperative complications in ES. METHODS: The 2011-2012 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was screened for all surgical operations classified as "emergent." Thirty-day postoperative complications were defined as per ACS-NSQIP (e.g., surgical site infection, respiratory failure, acute renal failure). Each patient-related ESS was calculated, and the correlation between ESS and the probability of occurrence of 30-day postoperative complications was assessed by calculating the c-statistic. Univariate and multivariable models were also created to identify which ESS components independently predict complications. RESULTS: Of 37,999 cases that captured all ESS variables, 14,446 (38%) resulted in at least one 30-day complication. The observed probability of a 30-day complication gradually increased from 7% to 53% to 91% at scores of 0, 7, and 15, respectively, with a c-statistic of 0.78. For ESS >15, the complication rate plateaued at a mean of 92%. On multivariable analyses, each of the 22 ESS components independently predicted the occurrence of postoperative complications. CONCLUSIONS:ESS reliably predicts postoperative complications in ES patients. Such a score could prove useful for (1) perioperative patient and family counseling and (2) benchmarking the quality of ES care. LEVEL OF EVIDENCE: Prognostic, level III.
Authors: Sigfredo Villarin; J Alford Flippin; Wyatt P Bensken; Eric Curfman; Christopher W Towe; Jeffrey A Claridge; Vanessa P Ho Journal: Surg Infect (Larchmt) Date: 2022-08 Impact factor: 1.853
Authors: Vanessa P Ho; Wyatt P Bensken; Heena P Santry; Christopher W Towe; David F Warner; Alfred F Connors; Siran M Koroukian Journal: Surgery Date: 2022-04-06 Impact factor: 4.348
Authors: R Nascimbeni; A Amato; R Cirocchi; A Serventi; A Laghi; M Bellini; G Tellan; M Zago; C Scarpignato; G A Binda Journal: Tech Coloproctol Date: 2020-11-05 Impact factor: 3.781