Division of Trauma, Emergency Surgery & Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
Division of Trauma, Emergency Surgery & Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.
Am J Surg. 2020 Dec;220(6):1613-1622. doi: 10.1016/j.amjsurg.2020.02.034. Epub 2020 Feb 19.
The Emergency Surgery Score (ESS) is an accurate mortality risk calculator for emergency general surgery (EGS). We sought to assess whether ESS can accurately predict 30-day morbidity, mortality, and requirement for postoperative Intensive Care Unit (ICU) care in patients with missing data variables.
All EGS patients with one or more missing ESS variables in the 2007-2015 ACS-NSQIP database were included. ESS was calculated assuming that a missing variable is normal (i.e. no additional ESS points). The correlation between ESS and morbidity, mortality, and postoperative ICU level of care was assessed using the c-statistics methodology.
Out of a total of 4,456,809 patients, 359,849 were EGS, and of those 256,278 (71.2%) patients had at least one ESS variable missing. ESS correlated extremely well with mortality (c-statistic = 0.94) and postoperative requirement of ICU care (c-statistic = 0.91) and well with morbidity (c-statistic = 0.77).
ESS performs well in predicting outcomes in EGS patients even when one or more data elements are missing and remains a useful bedside tool for counseling EGS patients and for benchmarking the quality of EGS care.
急诊外科评分（ESS）是一种针对急诊普通外科（EGS）的准确死亡率风险计算器。我们试图评估 ESS 是否可以准确预测在存在缺失数据变量的情况下患者的 30 天发病率、死亡率和术后需要重症监护病房（ICU）护理的情况。
在 2007-2015 年 ACS-NSQIP 数据库中，所有 EGS 患者中存在一个或多个缺失 ESS 变量的患者均被纳入研究。ESS 的计算假设缺失变量为正常（即不增加 ESS 点数）。使用 C 统计量方法评估 ESS 与发病率、死亡率和术后 ICU 护理水平之间的相关性。
在总共 4456809 名患者中，有 359849 名是 EGS，其中 256278 名（71.2%）患者至少有一个 ESS 变量缺失。ESS 与死亡率（C 统计量=0.94）和术后需要 ICU 护理的情况（C 统计量=0.91）相关性非常好，与发病率（C 统计量=0.77）相关性也很好。
即使存在一个或多个数据元素缺失，ESS 在预测 EGS 患者的结果方面表现良好，并且仍然是用于咨询 EGS 患者和评估 EGS 护理质量的有用床边工具。
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