Kao et al reported the CELIOtomy risk score for predicting early postoperative mortality following emergency laparotomy. This can help to identify a patient for whom surgery may be futile. The authors are from Carolinas Medical Center in Charlotte.
Patient selection: emergency laparotomy
Outcome: postoperative mortality, early if <= 72 hours
Parameters:
(1) age in years
(2) Glasgow coma scale (GCS)
(3) serum lactate in mmol/L
(4) arterial pH
(5) serum creatinine in mg/dL
Parameter
Finding
Points
age in years
< 50 years
0
50 to 59 years
1
60 to 69 years
2
>= 70 years
3
GCS
15
0
12 to 14
1
9 to 11
2
3 to 8
3
serum lactate
< 2 mmol/L
0
2 to 3.99 mmol/L
1
4 to 5.99 mmol/L
2
>= 6 mmol/L
5
arterial pH
> 7.35
0
7.25 to 7.34
1
7.10 to 7.24
2
< 7.1
4
serum creatinine
< 1 mg/dL
0
1 to 1.99 mg/dL
1
2 to 3.99 mg/dL
2
>= 4.0 mg/dL
3
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 18
• The higher the score the greater the risk of early mortality.
Score
Risk of Mortality
0 to 3
very low
4 to 6
low
7 to 9
low to moderate
10 to 12
moderate
13 to 15
high (> 50%)
>= 16
very high
Performance:
• The area under the ROC curve is 0.91.
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