aLicante sUrgical Community Emergencies New Tool for the enUmeration of Morbidities: a simplified auditing tool for community-acquired gastrointestinal surgical emergencies
| Autor: | Mariano Franco, C. Alcazar, Judit Parra, Silvia Carbonell, Ana Belén Apio, Noel Rojas, Luis Campos, María José Linares Gil, Monica Rey, Jose Antonio Bravo, José Luis Estrada, Rebeca Saeta, Pere Rebasa, Félix Lluís, Pedro Zapater, Estefanía Doménech, Javier Espinosa, David Negre, Miriam Lillo, Carmen Zaragoza, Luis Mena, Celia Villodre, Ibán Caravaca |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Scoring system Audit 030230 surgery Logistic regression Risk Assessment Severity of Illness Index Cohort Studies 03 medical and health sciences Postoperative Complications 0302 clinical medicine Predictive Value of Tests medicine Humans Prospective Studies Surgical emergency Digestive System Surgical Procedures Aged Abdomen Acute Medical Audit business.industry Extramural Morbidity risk General Medicine Middle Aged Survival Analysis Surgery Logistic Models Spain 030220 oncology & carcinogenesis Emergency medicine Cohort Female Observational study Emergencies Morbidity business |
| Zdroj: | The American Journal of Surgery. 212:917-926 |
| ISSN: | 0002-9610 |
| Popis: | Background In a previous study, we found that Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) overpredicts morbidity risk in emergency gastrointestinal surgery. Our aim was to find a POSSUM equation adjustment. Methods A prospective observational study was performed on 2,361 patients presenting with a community-acquired gastrointestinal surgical emergency. The first 1,000 surgeries constituted the development cohort, the second 1,000 events were the first validation intramural cohort, and the remaining 361 cases belonged to a second validation extramural cohort. Results (1) A modified POSSUM equation was obtained. (2) Logistic regression was used to yield a statistically significant equation that included age, hemoglobin, white cell count, sodium and operative severity. (3) A chi-square automatic interaction detector decision tree analysis yielded a statistically significant equation with 4 variables, namely cardiac failure, sodium, operative severity, and peritoneal soiling. Conclusions A modified POSSUM equation and a simplified scoring system (aLicante sUrgical Community Emergencies New Tool for the enUmeration of Morbidities [LUCENTUM]) are described. Both tools significantly improve prediction of surgical morbidity in community-acquired gastrointestinal surgical emergencies. |
| Databáze: | OpenAIRE |
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