Cordoba et al reported the USEM formula for predicting mortality in an elderly patient undergoing urgent surgery. The authors are from multiple institutions in Navarra, Spain.
Patient selection: urgent surgery in a patient > 65 years of age
Parameters:
(1) age in years
(2) diagnosis
(3) ASA score
(4) surgical wound classification
(5) type of surgery
Parameter
Finding
Points
age
(years) * 0.036
diagnosis
acute appendicitis
0
soft tissue abscess
0.037
acute cholecystitis
0.5
intra-abdominal abscess
0.531
incarcerated hernia
0.988
complicated peptic ulcer
1.113
colorectal obstruction
1.625
colorectal perforation
1.646
intestinal obstruction
1.907
polytrauma
2.048
lower GI bleeding
2.117
hepato/biliary/pancreatic
2.345
intestinal ischemia
3.633
other
2.089
ASA score
ASA I
0
ASA II
0.545
ASA III
1.317
ASA IV
2.263
ASA V
3.14
wound classification
clean or clean-contaminated
0
contaminated
0.469
dirty or infected
0.911
surgery
laparoscopic
0
open
0.953
value of X =
= SUM(points for all of the parameters) - 9.32
mortality risk =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.84.
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