Prediction of In-Hospital Mortality after Emergency Laparotomy Using Glasgow Coma Scale, ASA Physical Status...

Area of Science:

• General Surgery
• Surgical Outcomes
• Patient Prognosis

Background:

• Emergency laparotomies carry significant risks.
• Predicting mortality is crucial for patient management.
• The Glasgow Coma Scale (GCS), ASA physical status classification system, and P-POSSUM score are potential predictors.

Purpose of the Study:

• To evaluate the predictive importance of GCS, ASA classification, and P-POSSUM score for mortality in emergency laparotomy patients.

Main Methods:

• An analytical study was conducted on patients undergoing emergency laparotomies.
• Exclusions included trauma, re-do surgeries, and specific procedures (appendectomies, etc.).
• GCS, ASA, and P-POSSUM scores were categorized and analyzed for correlation with mortality.

Main Results:

• Out of 50 patients, 12 (24%) died. Mortality increased with higher P-POSSUM scores, lower GCS scores, and higher ASA classes (p <0.001).
• P-POSSUM demonstrated the highest predictive performance (0.987), followed by ASA (0.951).
• GCS showed lower predictive value (0.411).

Conclusions:

• The ASA Physical Status Classification System and P-POSSUM scoring are significant predictors of mortality following emergency laparotomy.
• These scoring systems can aid in risk stratification and patient management.