Emergency laparotomy preoperative risk assessment tool performance: A systematic review
Background: Preoperative assessment of risk for emergency laparotomy may enhance decision making with regards to urgency or perioperative critical care admission and promote a more informed consent process for patients. Accordingly, we aimed to assess the performance of risk assessment tools in pred...
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Elsevier
2024-12-01
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| Series: | Surgery in Practice and Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666262024000317 |
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| author | Joseph N. Hewitt Thomas J. Milton Jack Jeanes Ishraq Murshed Silas Nann Susanne Wells Aashray K. Gupta Christopher D. Ovenden Joshua G. Kovoor Stephen Bacchi Christopher Dobbins Markus I. Trochsler |
| author_facet | Joseph N. Hewitt Thomas J. Milton Jack Jeanes Ishraq Murshed Silas Nann Susanne Wells Aashray K. Gupta Christopher D. Ovenden Joshua G. Kovoor Stephen Bacchi Christopher Dobbins Markus I. Trochsler |
| author_sort | Joseph N. Hewitt |
| collection | DOAJ |
| description | Background: Preoperative assessment of risk for emergency laparotomy may enhance decision making with regards to urgency or perioperative critical care admission and promote a more informed consent process for patients. Accordingly, we aimed to assess the performance of risk assessment tools in predicting mortality after emergency laparotomy. Methods: PubMed, Embase, the Cochrane Library and CINAHL were searched to 12 February 2022 for observational studies reporting expected mortality based on a preoperative risk assessment and actual mortality after emergency laparotomy. Study screening, data extraction, and risk of bias using the Downs and Black checklist were performed in duplicate. Data on setting, operation undertaken, expected and actual mortality rates were extracted. Meta-analysis was planned but not possible due to heterogeneity. This study is registered with PROSPERO, CRD42022299227. Results: From 10,168 records, 82 observational studies were included. 17 risk assessment tools were described, the most common of which were P-POSSUM (42 studies), POSSUM (13 studies), NELA (12 studies) and MPI (11 studies). Articles were published between 1990 and 2022 with the most common country of origin being the UK (33 studies) followed by India (11 studies). Meta-analysis was not possible. Observed mortality and expected mortality based on risk assessment is reported for each study and generally shows most studies show accurate risk prediction. Conclusions: This review synthesises available literature to characterise the performance of various risk assessment tools in predicting mortality after emergency laparotomy. Findings from this study may benefit those undertaking emergency laparotomy and future research in risk prediction. |
| format | Article |
| id | doaj-art-e822b3d97d90490a8b2f55b7fef2db5d |
| institution | OA Journals |
| issn | 2666-2620 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Surgery in Practice and Science |
| spelling | doaj-art-e822b3d97d90490a8b2f55b7fef2db5d2025-08-20T01:58:30ZengElsevierSurgery in Practice and Science2666-26202024-12-011910026410.1016/j.sipas.2024.100264Emergency laparotomy preoperative risk assessment tool performance: A systematic reviewJoseph N. Hewitt0Thomas J. Milton1Jack Jeanes2Ishraq Murshed3Silas Nann4Susanne Wells5Aashray K. Gupta6Christopher D. Ovenden7Joshua G. Kovoor8Stephen Bacchi9Christopher Dobbins10Markus I. Trochsler11The University of Adelaide, Discipline of Surgery, The Queen Elizabeth Hospital, South Australia, Australia; Department of Surgery, Royal Adelaide Hospital, South Australia, Australia; Corresponding author at: Discipline of Surgery, The Queen Elizabeth Hospital, University of Adelaide, 28 Woodville Road, Woodville, SA, 5011, Australia.Department of Surgery, Royal Adelaide Hospital, South Australia, AustraliaCollege of Medicine and Public Health, Flinders University, South Australia, AustraliaThe University of Adelaide, Discipline of Surgery, The Queen Elizabeth Hospital, South Australia, AustraliaDepartment of Surgery, Gold Coast University Hospital, Queensland, AustraliaThe University of Adelaide, Discipline of Surgery, The Queen Elizabeth Hospital, South Australia, AustraliaDepartment of Surgery, Gold Coast University Hospital, Queensland, AustraliaDepartment of Surgery, Royal Adelaide Hospital, South Australia, AustraliaThe University of Adelaide, Discipline of Surgery, The Queen Elizabeth Hospital, South Australia, AustraliaThe University of Adelaide, Discipline of Surgery, The Queen Elizabeth Hospital, South Australia, AustraliaDepartment of Surgery, Royal Adelaide Hospital, South Australia, AustraliaThe University of Adelaide, Discipline of Surgery, The Queen Elizabeth Hospital, South Australia, AustraliaBackground: Preoperative assessment of risk for emergency laparotomy may enhance decision making with regards to urgency or perioperative critical care admission and promote a more informed consent process for patients. Accordingly, we aimed to assess the performance of risk assessment tools in predicting mortality after emergency laparotomy. Methods: PubMed, Embase, the Cochrane Library and CINAHL were searched to 12 February 2022 for observational studies reporting expected mortality based on a preoperative risk assessment and actual mortality after emergency laparotomy. Study screening, data extraction, and risk of bias using the Downs and Black checklist were performed in duplicate. Data on setting, operation undertaken, expected and actual mortality rates were extracted. Meta-analysis was planned but not possible due to heterogeneity. This study is registered with PROSPERO, CRD42022299227. Results: From 10,168 records, 82 observational studies were included. 17 risk assessment tools were described, the most common of which were P-POSSUM (42 studies), POSSUM (13 studies), NELA (12 studies) and MPI (11 studies). Articles were published between 1990 and 2022 with the most common country of origin being the UK (33 studies) followed by India (11 studies). Meta-analysis was not possible. Observed mortality and expected mortality based on risk assessment is reported for each study and generally shows most studies show accurate risk prediction. Conclusions: This review synthesises available literature to characterise the performance of various risk assessment tools in predicting mortality after emergency laparotomy. Findings from this study may benefit those undertaking emergency laparotomy and future research in risk prediction.http://www.sciencedirect.com/science/article/pii/S2666262024000317General surgeryEmergency laparotomyRisk assessment |
| spellingShingle | Joseph N. Hewitt Thomas J. Milton Jack Jeanes Ishraq Murshed Silas Nann Susanne Wells Aashray K. Gupta Christopher D. Ovenden Joshua G. Kovoor Stephen Bacchi Christopher Dobbins Markus I. Trochsler Emergency laparotomy preoperative risk assessment tool performance: A systematic review Surgery in Practice and Science General surgery Emergency laparotomy Risk assessment |
| title | Emergency laparotomy preoperative risk assessment tool performance: A systematic review |
| title_full | Emergency laparotomy preoperative risk assessment tool performance: A systematic review |
| title_fullStr | Emergency laparotomy preoperative risk assessment tool performance: A systematic review |
| title_full_unstemmed | Emergency laparotomy preoperative risk assessment tool performance: A systematic review |
| title_short | Emergency laparotomy preoperative risk assessment tool performance: A systematic review |
| title_sort | emergency laparotomy preoperative risk assessment tool performance a systematic review |
| topic | General surgery Emergency laparotomy Risk assessment |
| url | http://www.sciencedirect.com/science/article/pii/S2666262024000317 |
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