Predicting mortality and morbidity in emergency general surgery patients in a Jordanian Tertiary Medical Center: a retrospective validation study of the Emergency Surgery Score (ESS)
Objective The Emergency Surgery Score (ESS) is a predictive tool used to assess morbidity and mortality rates in patients undergoing emergent surgery. This study explores the ESS’s predictive ability and reliability in the Jordanian surgical population.Design A retrospective validation study.Setting...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2022-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/11/e061781.full |
| _version_ | 1811319519470157824 |
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| author | Liqaa Raffee Khaled Alawneh Sami A Almasarweh Fadi Issa Tagleb S Mazahreh Nadeem Bilal Alabdallah Mohammad A AL Hamoud Hamza A Aburayya Fadi S Ayoub Greg Ciottone |
| author_facet | Liqaa Raffee Khaled Alawneh Sami A Almasarweh Fadi Issa Tagleb S Mazahreh Nadeem Bilal Alabdallah Mohammad A AL Hamoud Hamza A Aburayya Fadi S Ayoub Greg Ciottone |
| author_sort | Liqaa Raffee |
| collection | DOAJ |
| description | Objective The Emergency Surgery Score (ESS) is a predictive tool used to assess morbidity and mortality rates in patients undergoing emergent surgery. This study explores the ESS’s predictive ability and reliability in the Jordanian surgical population.Design A retrospective validation study.Setting A tertiary hospital in Jordan.Participants A database was created including patients who underwent emergent surgery in King Abdullah University Hospital from January 2017 to June 2021.Primary and secondary outcome measures Relevant preoperative, intraoperative and postoperative variables were retrospectively and systematically gathered, and the ESS was calculated for each patient accordingly. In addition, a multivariable logistic regression analysis was performed to assess the correlations between the ESS and postoperative mortality and morbidity along with intensive care unit (ICU) admissions.Results Out of total of 1452 patients evaluated, 1322 patients were enrolled based on inclusion and exclusion criteria. The mean age of the population was 47.9 years old. 91.9% of the patients were admitted to the surgical ward through the emergency department, while the rest were referred from inpatient and outpatient facilities. The mortality and postoperative complication rates were 3.9% and 13.5%, respectively. Mortality rates increased as the ESS score gradually increased, and the ESS was evaluated as a strong predictor with a c-statistic value of 0.842 (95% CI 0.743 to 0.896). The postoperative complication and ICU admission rate also increased with reciprocal rises in the ESS. They were also evaluated as accurate predictors with a c-statistic value of 0.724 (95% CI 0.682 to 0.765) and a c-statistic value of 0.825 (95% CI 0.784 to 0.866), respectively.Conclusion The ESS is a robust, accurate predictor of postoperative mortality and morbidity of emergency general surgery patients. Furthermore, it is an all-important tool to enhance emergency general surgery practices, in terms of mitigating risk, quality of care measures and patient counselling. |
| first_indexed | 2024-04-13T12:44:32Z |
| format | Article |
| id | doaj.art-3b5fca82281d40749c40bb19f9e68ccf |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-04-13T12:44:32Z |
| publishDate | 2022-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-3b5fca82281d40749c40bb19f9e68ccf2022-12-22T02:46:24ZengBMJ Publishing GroupBMJ Open2044-60552022-11-01121110.1136/bmjopen-2022-061781Predicting mortality and morbidity in emergency general surgery patients in a Jordanian Tertiary Medical Center: a retrospective validation study of the Emergency Surgery Score (ESS)Liqaa Raffee0Khaled Alawneh1Sami A Almasarweh2Fadi Issa3Tagleb S Mazahreh4Nadeem Bilal Alabdallah5Mohammad A AL Hamoud6Hamza A Aburayya7Fadi S Ayoub8Greg Ciottone9Accidents and Emergency, Jordan University of Science and Technology, Irbid, JordanDiagnostic Radiology and Nuclear Medicine, Jordan University of Science and Technology, Irbid, JordanAccidents and Emergency, Jordan University of Science and Technology, Irbid, JordanTransplantation Research Immunology Group, University of Oxford Nuffield Department of Surgical Sciences, Oxford, UKDepartment of Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid, JordanFaculty of Medicine, Jordan University of Science and Technology, Irbid, JordanIntern, King Abdullah University Hospital, Ramtha, Irbid, JordanFaculty of Medicine, Jordan University of Science and Technology, Irbid, JordanFaculty of Medicine, Jordan University of Science and Technology, Irbid, JordanBIDMC Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USAObjective The Emergency Surgery Score (ESS) is a predictive tool used to assess morbidity and mortality rates in patients undergoing emergent surgery. This study explores the ESS’s predictive ability and reliability in the Jordanian surgical population.Design A retrospective validation study.Setting A tertiary hospital in Jordan.Participants A database was created including patients who underwent emergent surgery in King Abdullah University Hospital from January 2017 to June 2021.Primary and secondary outcome measures Relevant preoperative, intraoperative and postoperative variables were retrospectively and systematically gathered, and the ESS was calculated for each patient accordingly. In addition, a multivariable logistic regression analysis was performed to assess the correlations between the ESS and postoperative mortality and morbidity along with intensive care unit (ICU) admissions.Results Out of total of 1452 patients evaluated, 1322 patients were enrolled based on inclusion and exclusion criteria. The mean age of the population was 47.9 years old. 91.9% of the patients were admitted to the surgical ward through the emergency department, while the rest were referred from inpatient and outpatient facilities. The mortality and postoperative complication rates were 3.9% and 13.5%, respectively. Mortality rates increased as the ESS score gradually increased, and the ESS was evaluated as a strong predictor with a c-statistic value of 0.842 (95% CI 0.743 to 0.896). The postoperative complication and ICU admission rate also increased with reciprocal rises in the ESS. They were also evaluated as accurate predictors with a c-statistic value of 0.724 (95% CI 0.682 to 0.765) and a c-statistic value of 0.825 (95% CI 0.784 to 0.866), respectively.Conclusion The ESS is a robust, accurate predictor of postoperative mortality and morbidity of emergency general surgery patients. Furthermore, it is an all-important tool to enhance emergency general surgery practices, in terms of mitigating risk, quality of care measures and patient counselling.https://bmjopen.bmj.com/content/12/11/e061781.full |
| spellingShingle | Liqaa Raffee Khaled Alawneh Sami A Almasarweh Fadi Issa Tagleb S Mazahreh Nadeem Bilal Alabdallah Mohammad A AL Hamoud Hamza A Aburayya Fadi S Ayoub Greg Ciottone Predicting mortality and morbidity in emergency general surgery patients in a Jordanian Tertiary Medical Center: a retrospective validation study of the Emergency Surgery Score (ESS) BMJ Open |
| title | Predicting mortality and morbidity in emergency general surgery patients in a Jordanian Tertiary Medical Center: a retrospective validation study of the Emergency Surgery Score (ESS) |
| title_full | Predicting mortality and morbidity in emergency general surgery patients in a Jordanian Tertiary Medical Center: a retrospective validation study of the Emergency Surgery Score (ESS) |
| title_fullStr | Predicting mortality and morbidity in emergency general surgery patients in a Jordanian Tertiary Medical Center: a retrospective validation study of the Emergency Surgery Score (ESS) |
| title_full_unstemmed | Predicting mortality and morbidity in emergency general surgery patients in a Jordanian Tertiary Medical Center: a retrospective validation study of the Emergency Surgery Score (ESS) |
| title_short | Predicting mortality and morbidity in emergency general surgery patients in a Jordanian Tertiary Medical Center: a retrospective validation study of the Emergency Surgery Score (ESS) |
| title_sort | predicting mortality and morbidity in emergency general surgery patients in a jordanian tertiary medical center a retrospective validation study of the emergency surgery score ess |
| url | https://bmjopen.bmj.com/content/12/11/e061781.full |
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