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Comparison of different scoring systems in predicting mortality and postoperative complications in acute care surgery patients at a Saudi Academic Centre

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Abstract

Purpose

Emergency surgery carries an increased risk of death and complications. Scoring systems can help identify patients at higher risk of mortality and complications. Scoring systems can also help benchmark acute care services. This study aims to compare different scoring systems in predicting outcomes among acute care surgery patients.

Methods

Our study is a retrospective cohort study that included all adult emergency surgery admissions between 2017 and 2019. Data were obtained from patients' electronic health records. Same admission mortality and postoperative complications were collected. Data were recorded to calculate the American Society of Anesthesiologists Physical Status classification system (ASA-PS), Shock Index Score (SI), Age Shock Index Score (AgeSI), and the Emergency Surgery Score (ESS). The probability of death and complications was correlated with each scoring system and was assessed by calculating the c-statistic.

Results

During the study period, 1606 patients fulfilled inclusion criteria. The mortality rate was 2.2%, complication rate was 18.7%. ESS predicted mortality with a c-statistic of 0.87 better than ASA-PS, AgeSI, and SI with a calculated c-statistic of 0.81, 0.74, and 0.57, respectively. ESS also predicted the occurrence of complications with a c-statistic of 0.83 better than ASA-PS, AgeSI, and SI with a calculated c-statistic of 0.72, 0.71, and 0.63, respectively.

Conclusion

ESS demonstrated a better prognostic accuracy for hospital mortality and postoperative complications than other prognostic scoring systems. Our findings suggest that a scoring system designed for the acute care surgical population may provide enhanced prognostic performance over other surgical prognostic scoring systems.

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Data availability

The datasets analyzed during the current work are available from the corresponding author upon reasonable request.

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Funding

This research did not receive any specific Grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Trauma and Acute Care Surgery Unit, Department of Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia

    Thamer Nouh & Ahmed Alburakan

  2. College of Medicine, King Saud University, Riyadh, Saudi Arabia

    Norah Alkadi, Lamis Alsuwailem, Albatoul Alshanaifi & Rahaf Alshunaiber

Authors
  1. Thamer Nouh
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  2. Norah Alkadi
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  3. Lamis Alsuwailem
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  4. Albatoul Alshanaifi
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  5. Rahaf Alshunaiber
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  6. Ahmed Alburakan
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Corresponding author

Correspondence to Thamer Nouh.

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Conflict of interest

Thamer Nouh, Norah Alkadi, Lamis Alsuwailem, Albatoul Alshanaifi, Rahaf Alshunaiber, and Ahmed Alburakan have no conflict of interest to disclose.

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Nouh, T., Alkadi, N., Alsuwailem, L. et al. Comparison of different scoring systems in predicting mortality and postoperative complications in acute care surgery patients at a Saudi Academic Centre. Eur J Trauma Emerg Surg 49, 1321–1327 (2023). https://doi.org/10.1007/s00068-023-02218-8

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  • DOI: https://doi.org/10.1007/s00068-023-02218-8

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