Development and validation of a prognostic model for death 30 days after adult emergency laparotomy
Authors' conclusion
In conclusion, we think that this prognostic model is suitable to support decision-making before emergency laparotomy as well as for risk adjustment for comparing organisations.
Study context
- Population
- Adults undergoing emergency laparotomy (indications: obstruction, sepsis, ischaemia, bleeding, other)
- Participants
- 40,816 vs 11,187
- Comparison
- Derivation vs Test
- Derivationn = 40,816
- Testn = 11,187
- Outcome
- Death
- Follow-up
- 30 days after surgery
Methodological detailsderivation and temporal test cohorts, National Emergency Laparotomy Audit data
- Derivation and temporal test cohorts
- National Emergency Laparotomy Audit data
Performance
As reported in the abstract
Model performance in test cohort
| Test or model | Value | Scaled Brier score | Integrated calibration index | Concordance |
|---|---|---|---|---|
| Test | 1888 events | 20% | 0.006 | 0.86 |
Test
Value1888 events
Scaled Brier score20%
Integrated calibration index0.006
Concordance0.86
Further findings
- 30-day mortality, derivation cohort · 30 days after surgery
- 10% · 4077 of 40,816
Final model and predicted mortality
- Final model pre-operative variables (surgical indication, age, BP, heart rate, respiratory history, urgency, biochemical markers, anticipated malignancy, anticipated peritoneal soiling, ASA physical status)
- 13
- Predicted mortality probability deciles range
- 0.1% to 47%
Original publication
Development and validation of a prognostic model for death 30 days after adult emergency laparotomy. Anaesthesia. Published 14 July 2023. doi:10.
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