Haskins et al reported a risk calculator for 30-day mortality after emergency general surgery. It was derived based on the ACS NSQIP database. The authors are from the George Washington University in Washington, D.C.
Patient selection: adult undergoing emergency general surgery (age range 63 +/0 17)
Parameters:
(1) age in years
(2) preoperative sepsis
(3) functional status
(4) serum BUN in mg/dL
(5) serum albumin in g/dL
Parameter
Finding
Points
age in years
0.034 *
preoperative sepsis
no
0
yes
0.88
functional status
independent
0
not independent
0.8
serum BUN
< 18 mg/dL
0
18 to 28.99 mg/dL
0.57
>= 29 mg/dL
1.1
serum albumin
>= 3.4 g/dL
0
2.7 to 3.39 g/dL
0.61
< 2.7 g/dL
1.16
risk of 30-day mortality =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: around 1 (depending on age)
• maximum score: around 7.34 (depending on age)
• maximum score of components without age: 3.94
• The authors indicate that the risk in the patients ranged from 2% to 31%.
• The gap between the score result and the reported risk is not explained.
• One possible explanation would be to use the score in a logistic regression model with the constant around -7.4.
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