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World Journal of Surgery

Published in:

01-07-2017 | Original Scientific Report

Derivation and Validation of a Novel Physiological Emergency Surgery Acuity Score (PESAS)

Authors: Naveen F. Sangji, Jordan D. Bohnen, Elie P. Ramly, George C. Velmahos, David C. Chang, Haytham M. A. Kaafarani

Published in: World Journal of Surgery | Issue 7/2017

Abstract

Background

We present a novel and abbreviated Physiological Emergency Surgery Acuity Score (PESAS) that assesses the severity of disease at presentation in patients undergoing Emergency Surgery (ES).

Methods

Using the 2011 ACS-NSQIP database, we identified all patients who underwent “emergent” surgery. The following methodology was designed: (1) identification of independent predictors of 30-day mortality that are markers of acuity; (2) derivation of PESAS based on the relative impact (i.e., odds ratio) of each predictor; and (3) measurement of the c-statistic. The PESAS was validated using the 2012 ACS-NSQIP database.

Results

From 24,702 ES cases, a 15-point score was derived. This included 10 components with a range of 0 and 15 points. Its c-statistic was 0.80. Mortality gradually increased from 1.7 to 40.6 to 100% at scores of 0, 8, and 15, respectively. In the validation phase, PESAS c-statistic remained stable.

Conclusion

PESAS is a novel score that assesses the acuity of disease at presentation in ES patients and strongly correlates with postoperative mortality risk. PESAS could prove useful for preoperative counseling and for risk-adjusted benchmarking.

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Title: Derivation and Validation of a Novel Physiological Emergency Surgery Acuity Score (PESAS)
Authors: Naveen F. Sangji
Jordan D. Bohnen
Elie P. Ramly
George C. Velmahos
David C. Chang
Haytham M. A. Kaafarani
Publication date: 01-07-2017
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 7/2017
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-017-3915-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Derivation and Validation of a Novel Physiological Emergency Surgery Acuity Score (PESAS)

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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