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急诊手术评分作为急诊手术患者有效风险分层工具的叙述性综述

Emergency Surgery Score as an Effective Risk Stratification Tool for Patients Undergoing Emergency Surgeries: A Narrative Review.

作者信息

Saxena Pravin, Nair Abhijit

机构信息

Department of Cardiac Anesthesia, National Heart Center, Royal Hospital, Muscat, OMN.

Anesthesiology, Ibra Hospital, Ibra, OMN.

出版信息

Cureus. 2022 Jun 23;14(6):e26226. doi: 10.7759/cureus.26226. eCollection 2022 Jun.

Abstract

Several risk stratification tools have been described for quantifying perioperative morbidity, mortality, and adverse events in patients undergoing elective and emergency surgeries. These tools help in decision-making, determining the prognosis and communicating it with patients and family members, and planning admissions to the intensive care units (ICU) if necessary. Emergency surgery poses quite a unique challenge in terms of deranged physiology, age, and comorbid conditions, and often carries a higher incidence of morbidity and mortality. Very few risk stratification tools are available to reliably predict the risk posed by emergency surgical interventions. One of the recently described tools is the Emergency Surgery Score (ESS), which comprises three demographic variables, 10 comorbidities, and nine laboratory variables, the scores of which add up to 29. Several studies have demonstrated that ESS reliably predicts morbidity, mortality, and the need for ICU admission, predicting infectious complications like pneumonia and renal failure. In this review, we analyze the current literature to investigate the efficacy and reliability of ESS as a risk stratification tool for patients undergoing emergency surgeries.

摘要

已经描述了几种风险分层工具,用于量化接受择期和急诊手术患者的围手术期发病率、死亡率和不良事件。这些工具有助于决策、确定预后并与患者及其家属沟通,必要时还可用于规划重症监护病房(ICU)的收治。急诊手术在生理紊乱、年龄和合并症方面带来了相当独特的挑战,且往往发病率和死亡率较高。很少有风险分层工具能够可靠地预测急诊手术干预带来的风险。最近描述的工具之一是急诊手术评分(ESS),它包括三个人口统计学变量、10种合并症和9个实验室变量,这些变量的得分加起来为29分。多项研究表明,ESS能够可靠地预测发病率、死亡率以及入住ICU的必要性,还能预测诸如肺炎和肾衰竭等感染性并发症。在本综述中,我们分析当前文献,以研究ESS作为急诊手术患者风险分层工具的有效性和可靠性。

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