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  • Quick shot presentation
  • QSP4.03

Prospective multicenter external validation of postoperative mortality prediction tools in patients undergoing emergency laparotomy

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Stih hall

Session

Oral Quick Shot Presentation 4

Topics

  • Education
  • Emergency surgery

Authors

Stamatios Kokkinakis (Heraklion / GR), Evangelos Kritsotakis (Heraklion / GR), Konstantinos Paterakis (Heraklion / GR), Garyfallia-Apostolia Karali (Heraklion / GR), Vironas Malikides (Heraklion / GR), Anna Kyprianou (Heraklion / GR), Melina Papalexandraki (Heraklion / GR), Charalambos Anastasiadis (Heraklion / GR), Odysseas Zoras (Heraklion / GR), Nikolas Drakos (Patras / GR), Ioannis Kehagias (Patras / GR), Dimitrios Kehagias (Patras / GR), Nikolaos Gouvas (Nicosia / CY), Georgios Kokkinos (Nicosia / CY), Ioanna Pozotou (Nicosia / CY), Panagiotis Papatheodorou (Nicosia / CY), Kyriakos Frantzeskou (Nicosia / CY), Dimitrios Schizas (Athens / GR), Athanasios Syllaios (Athens / GR), Ifestion Palios (Athens / GR), Konstantinos Nastos (Athens / GR), Markos Perdikaris (Athens / GR), Nikolaos Michalopoulos (Athens / GR), Ioannis Margaris (Athens / GR), Evangelos Lolis (Volos / GR), Georgia Dimopoulou (Volos / GR), Dimitrios Panagiotou (Trikala / GR), Vasiliki Nikolaou (Trikala / GR), Georgios Glantzounis (Ioannina / GR), George Pappas-Gogos (Ioannina / GR), Kostas Tepelenis (Ioannina / GR), Georgios Zacharioudakis (Thessaloniki / GR), Savvas Tsaramanidis (Thessaloniki / GR), Ioannis Patsarikas (Thessaloniki / GR), Georgios Stylianidis (Athens / GR), George Giannos (Athens / GR), Michail Karanikas (Alexandroupolis / GR), Konstantinia Kofina (Alexandroupolis / GR), Markos Markou (Alexandroupolis / GR), Emmanuel Chrysos (Heraklion / GR), Konstantinos Lasithiotakis (Heraklion / GR)

Abstract

Abstract text (incl. references and figure legends)

Introduction: Risk stratification in emergency laparotomy (EL) is essential for informed decision-making and rational use of resources. Available risk prediction tools have not been validated adequately across diverse healthcare settings. In this study, we aim to perform a comparative external validation of 4 widely cited prognostic models.

Materials and Methods: This is a multicenter study including consecutive patients undergoing EL in Greek hospitals. Inclusion and exclusion criteria of the National Emergency Laparotomy Audit (NELA) were used for validation of NELA risk calculator. Data capture will be done with the use of Redcap software. With an estimated postoperative mortality of around 15% based on an initial pilot stydy, a total of 650 patients will be required for an adequate sample size of at least 100 events. 30-day mortality risk predictions will be calculated for each patient using the American College of Surgeons – National Surgical Quality Improvement Program Surgical Risk Calculator, (ACS-SRC), surgeon-adjusted ACS-SRC, NELA, Portsmouth-Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (P-POSSUM) and Predictive OpTimal Trees in Emergency Surgery Risk (POTTER) tools. Predictive performances will be compared using scaled Brier scores, discrimination and calibration measures and plots, and decision curve analysis. Heterogeneity across hospitals will be assessed by random-effects meta-analysis.

Results: With the participation of 12 Surgical Departments the appropriate data collection time will require 12-18 months and the publication of the comparative analysis is expected before the end of 24 months from the initiation of the study.

Conclusions: This is the first study to compare 4 risk prediction tools in a prospective setting in European EL patients.

References:

1. 10.1016/j.jamcollsurg.2013.07.385

2. 10.1016/j.bja.2018.06.026

3. 10.1046/j.1365-2168.1998.00840.x

4. 10.1097/SLA.0000000000002956

Disclosure: Do you have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstract? (If not, please enter "No" in the text field.)

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