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Related Experiment Video

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30-Day mortality risk predictors for emergency laparotomy: a comparative study.

M Hassan1, K AbdelSaid1, A K Ebrahim1

  • 1Maidstone and Tunbridge Wells NHS Trust, UK.

Annals of the Royal College of Surgeons of England
|January 12, 2026
PubMed
Summary
This summary is machine-generated.

The National Emergency Laparotomy Audit (NELA) score best predicts mortality risk in emergency laparotomy patients. This study compared NELA with P-POSSUM, ACS-NSQIP, and SORT, finding NELA most effective for identifying high-risk individuals.

Keywords:
ACS-NSQIPLaparotomyNELAP-POSSUMSORT

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Area of Science:

  • Surgical Outcomes Research
  • Patient Risk Stratification
  • Emergency General Surgery

Background:

  • Emergency laparotomies carry significant risks of morbidity and mortality.
  • Accurate risk assessment tools are crucial for informed clinical decision-making.
  • Evaluating existing scoring systems is essential for improving patient care.

Purpose of the Study:

  • To compare the accuracy of four risk calculators in predicting 30-day mortality after emergency laparotomy.
  • To identify the most effective scoring system for identifying high-risk patients undergoing emergency laparotomy.

Main Methods:

  • Retrospective analysis of 227 adult patients undergoing emergency laparotomy.
  • Preoperative mortality risk calculated using National Emergency Laparotomy Audit (NELA), P-POSSUM, ACS-NSQIP, and SORT.
  • Comparison of sensitivity, specificity, and area under the curve (AUC) for each risk calculator.

Main Results:

  • NELA and P-POSSUM identified the most patients (73.3%) in the high-risk group who subsequently died.
  • NELA and ACS-NSQIP demonstrated the highest area under the curve (0.869 and 0.877, respectively).
  • NELA showed higher sensitivity (73.3%), while ACS-NSQIP had greater specificity (88.7%).

Conclusions:

  • The National Emergency Laparotomy Audit (NELA) score exhibits the highest overall performance in predicting mortality for emergency laparotomies.
  • NELA is a valuable tool for risk stratification in patients undergoing emergency laparotomy.