Perioperative medicine & outcomes
Validation of the National Emergency Laparotomy Audit (NELA) risk prediction model in emergency abdominal surgery
Authors' conclusion
The updated NELA risk prediction model performs well in this external validation study and may be used in similar settings.
Study context
- Population
- Adults undergoing emergency laparotomy at Zealand University Hospital (March 2017–January 2019) and Herlev Hospital (November 2017–January 2020)146 (11.9%) died within 30 days
- Participants
- 1,226 adults
- Comparison
- Updated NELA model vs original NELA, P-POSSUM and American Society of Anesthesiologists Physical Status (ASA-PS)
- Outcome
- 30-day mortality
- Follow-up
- 30 days
Methodological detailsretrospective data collection, two-centre, Variables collected retrospectively from electronic patient records
- Retrospective data collection
- Two-centre
- Variables collected retrospectively from electronic patient records
Performance
As reported in the abstract
Discrimination for 30-day mortality (AUC)
| Test or model | AUC (95% CI) |
|---|---|
| Updated NELA | 0.85 (0.82-0.88) |
| Original NELA | 0.84 (0.81-0.87) |
| P-POSSUM | 0.81 (0.77-0.84) |
| ASA-PS | 0.76 (0.72-0.79) |
AUC (95% CI)
Updated NELA0.85 (0.82-0.88)
Original NELA0.84 (0.81-0.87)
P-POSSUM0.81 (0.77-0.84)
ASA-PS0.76 (0.72-0.79)
Further findings
Calibration (Cox calibration regression)
- Underestimation of mortality risk for updated NELA, original NELA and P-POSSUM models
Original publication
Validation of the NELA risk prediction model in emergency abdominal surgery. Acta Anaesthesiol Scand. Published 23 June 2023. doi:10.
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