A novel simplified scoring system for predicting mortality in emergency colorectal surgery: prediction model development
São Paulo med. j
;
137(2): 132-136, Mar.-Apr. 2019. tab, graf
Article
in English
| LILACS
| ID: biblio-1014629
ABSTRACT
ABSTRACT BACKGROUND:
Despite advances in surgical approaches, emergency colorectal surgery has high mortality and morbidity.OBJECTIVE:
We aimed to create a simple and distinctive scoring system, for predicting mortality among patients undergoing emergency colorectal surgery. DESIGN ANDSETTING:
Prediction model development study based on retrospective data-gathering.METHODS:
Patients who underwent emergency colorectal surgery between March 2014 and December 2016 at a single tertiary-level referral center were included in our study. Patient demographics, comorbidities, type of surgery, etiology and laboratory and radiological findings were collected retrospectively and analyzed. A new clinical score (named the Numune emergency colorectal resection score) was constructed from the last logistic regression model, in which one point was assigned for the presence of each predictive factor.RESULTS:
138 patients underwent emergency colorectal surgery. These comprised 64 males (46.4%) and 74 females (53.6%), with a mean age of 64 years. Multivariate analysis revealed that blood urea nitrogen level > 65 mg/dl (odds ratio, OR 8.03; 95% confidence interval, CI 2.16-15.77), albumin level < 0.7 mg/dl (OR 4.43; 95% CI 1.96-14.39) and American Society of Anesthesiologists score ≥ 3 (OR 3.47; 95% CI 0.81-9.18) were associated with postoperative complications. The Numune score was graded from I to III. The risk of mortality was found to be 63.2% in the group with grade III, which accounted for 35.2% of the subjects. There were 37 postoperative deaths.CONCLUSIONS:
Surgeons need scoring systems, especially to predict postoperative mortality. We propose the Numune emergency colorectal resection score for emergency surgical procedures as a practical, usable and effective system for predicting postoperative morbidity.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Colorectal Surgery
/
Colonic Diseases
/
Risk Assessment
/
Emergency Treatment
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
English
Journal:
São Paulo med. j
Journal subject:
Cirurgia Geral
/
Cincia
/
Ginecologia
/
Medicine
/
Medicina Interna
/
Obstetr¡cia
/
Pediatria
/
Sa£de Mental
/
Sa£de P£blica
Year:
2019
Type:
Article
Affiliation country:
Turkey
Institution/Affiliation country:
Ankara Numune Egitim ve Arastirma Hastanesi/TR
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