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aLicante sUrgical Community Emergencies New Tool for the enUmeration of Morbidities: a simplified auditing tool for community-acquired gastrointestinal surgical emergencies
- Source :
- The American Journal of Surgery. 212:917-926
- Publication Year :
- 2016
- Publisher :
- Elsevier BV, 2016.
-
Abstract
- Background In a previous study, we found that Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) overpredicts morbidity risk in emergency gastrointestinal surgery. Our aim was to find a POSSUM equation adjustment. Methods A prospective observational study was performed on 2,361 patients presenting with a community-acquired gastrointestinal surgical emergency. The first 1,000 surgeries constituted the development cohort, the second 1,000 events were the first validation intramural cohort, and the remaining 361 cases belonged to a second validation extramural cohort. Results (1) A modified POSSUM equation was obtained. (2) Logistic regression was used to yield a statistically significant equation that included age, hemoglobin, white cell count, sodium and operative severity. (3) A chi-square automatic interaction detector decision tree analysis yielded a statistically significant equation with 4 variables, namely cardiac failure, sodium, operative severity, and peritoneal soiling. Conclusions A modified POSSUM equation and a simplified scoring system (aLicante sUrgical Community Emergencies New Tool for the enUmeration of Morbidities [LUCENTUM]) are described. Both tools significantly improve prediction of surgical morbidity in community-acquired gastrointestinal surgical emergencies.
- Subjects :
- Male
medicine.medical_specialty
Scoring system
Audit
030230 surgery
Logistic regression
Risk Assessment
Severity of Illness Index
Cohort Studies
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Predictive Value of Tests
medicine
Humans
Prospective Studies
Surgical emergency
Digestive System Surgical Procedures
Aged
Abdomen, Acute
Medical Audit
business.industry
Extramural
Morbidity risk
General Medicine
Middle Aged
Survival Analysis
Surgery
Logistic Models
Spain
030220 oncology & carcinogenesis
Emergency medicine
Cohort
Female
Observational study
Emergencies
Morbidity
business
Subjects
Details
- ISSN :
- 00029610
- Volume :
- 212
- Database :
- OpenAIRE
- Journal :
- The American Journal of Surgery
- Accession number :
- edsair.doi.dedup.....980f19879f59ca63c47d61d90a187e0d