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CC BY 4.0 · Surg J (N Y) 2022; 08(03): e270-e278
DOI: 10.1055/s-0042-1756461
Original Article

Emergency General Surgery: Predicting Morbidity and Mortality in the Geriatric Population

Abubaker Elamin    *
1   IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
2   Nottingham University Hospitals, Nottingham, United Kingdom
,
Panagiotis Tsoutsanis    *
1   IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
3   Ipswich Hospital, Ipswich, United Kingdom
,
Laith Sinan 
2   Nottingham University Hospitals, Nottingham, United Kingdom
,
Seyedh Paniz Hashemi Tari
1   IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
,
Wafa Elamin
4   Teesside University, Middlesbrough, United Kingdom
,
Hayato Kurihara 
1   IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
› Author Affiliations Funding The authors received no funding for this work.
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Addendum: Emergency General Surgery: Predicting Morbidity and Mortality in the Geriatric PopulationSurg J (N Y) 2022; 08(04): e341-e341
DOI: 10.1055/s-0042-1758693

Abstract

Introduction Numerous scoring systems have been created to predict the risk of morbidity and mortality in patients undergoing emergency general surgery (EGS).

In this article, we compared the different scoring systems utilized at Humanitas Research Hospital and analyzed which one performed the best when assessing geriatric patients (>65 years of age). The scoring systems that were utilized were the APACHE II (Acute Physiology and Chronic Health Evaluation II), ASA (American Society of Anesthesiologists), ACS-NSQIP (American College of Surgeons-National Surgical Quality Improvement Program), Clinical Frailty Score, and the Clavien–Dindo classification as control.

Materials and Methods We compiled a database consisting of all patients over the age of 65 who underwent EGS in a consecutive 24-month period between January 1, 2017 and December 31, 2018. We used the biostatistical program “Stata Version 15” to analyze our results.

Results We found 213 patients who matched our inclusion criteria. Regarding death, we found that the ACS-NSQIP death calculator performed the best with an area under the curve of 0.9017 (odds ratio: 1.09; 95% confidence interval: 1.06–1.12). The APACHE II score had the lowest discriminator when predicting death. Considering short-term complications, the Clavien–Dindo classification scored highly, while both the APACHE II score and Clinical Frailty Score produced the lowest results.

Conclusion The results obtained from our research showed that scoring systems and classifications produced different results depending on whether they were used to predict deaths or short-term complications among geriatric patients undergoing EGS.

Keywords

emergency general surgery - surgery - elderly - scoring systems - APACHE II - ASA - ACS-NSQIP - clinical frailty score - Clavien–Dindo

* Co-first authors.


Ethics Approval

Patient data from the participating patients in the EGS were collected in line with local ethics guidelines. Ethical approval was obtained from Humanitas Research Hospital before the research was conducted.


Author Contributions

A.E. and S.P.H.T. collected the patient data. A.E. and P.T. analyzed the data. A.E., P.T., L.S., S.P.H.T., H.K., and W.E. drafted the manuscript and subsequently revised it. All authors approved the final version of the manuscript.




Publication History

Received: 08 June 2022

Accepted: 28 July 2022

Article published online:
26 September 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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