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Comparing mortality calculators for emergency laparotomy in Cape Town
Introduction Emergency laparotomies (EL) are high risk surgeries, a result consistent across multiple national databases and audits. Risk prediction calculators (RPC) were developed to accurately stratify risk of mortality in these emergency patients, often frail prior to surgery. Access to post-ope...
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| Format: | Thesis |
| Language: | English |
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Division of General Surgery
2024
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| Summary: | Introduction Emergency laparotomies (EL) are high risk surgeries, a result consistent across multiple national databases and audits. Risk prediction calculators (RPC) were developed to accurately stratify risk of mortality in these emergency patients, often frail prior to surgery. Access to post-operative care including high-care and Intensive Care Unit is limited in LMIC hospitals. Aims and Methods To determine the risk of mortality following surgery using three risk prediction calculators – namely National Emergency Laparotomy Audit's New Risk Prediction Calculator (NELANRPC), Portsmouth Physiological and Operative Society Score (P-POSSUM), and African Surgical Outcomes Study (ASOS) to 215 patients who underwent non-trauma EL in a tertiary level hospital in South Africa. Results Mortality on post-operative day 30 in this cohort was 24.2%. Colorectal resections were most performed and had the highest mortality rate (30.6%). For risk prediction calculators, the NRPC had the largest AUC-ROC (0.86 95% CI, 0.803 to 0.920), followed by P-POSSUM (0.84 95% CI, 0.780 to 0.899), and ASOS (0.806 95% CI, 0.74 to 0.87) having the least. |
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