Validation of the preoperative score to predict postoperative mortality (POSPOM) in patients undergoing major emergency abdominal surgery

Simon Juul*, Dunja Kokotovic, Thea Helene Degett, Jakob Ohm Oreskov, Sarah Ekeloef, Ismail Gögenur, Jakob Burcharth

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftArtikelForskningpeer review

Abstract

PURPOSE: Patients undergoing major emergency abdominal surgery have a high mortality rate. Preoperative risk prediction tools of in-hospital mortality could assist clinical identification of patients at increased risk and thereby aid clinical decision-making and postoperative pathways. The aim of this study was to validate the preoperative score to predict mortality (POSPOM) in a population of patients undergoing major emergency abdominal surgery.

METHODS: POSPOM was investigated in a retrospectively collected cohort of patients undergoing major emergency abdominal surgery at a Danish University Hospital from 2010 to 2016. Predicted in-hospital mortality by POSPOM was compared to observed in-hospital mortality. Calibration was assessed by Hosmer-Lemeshow goodness-of-fit and calibration plot. Discrimination was assessed by area under the receiver operating characteristic curve and accuracy was assessed with Brier score.

RESULTS: The study included 979 patients (513 females) with a median age of 64 (IQR 55-77) years. The majority of patients underwent open surgery (94.5%). The observed in-hospital mortality rate was 10.9%. The estimated mean in-hospital mortality rate by POSPOM was 6.7%. POSPOM showed a good discrimination [AUC 0.82 (95% CI 0.78-0.85)] and an excellent accuracy [Brier score 0.09 (95% CI 0.07-0.10)]. However, a poor calibration was found (p?<?0.01) as POSPOM underestimated in-hospital mortality.

CONCLUSIONS: POSPOM is not an ideal prediction model for in-hospital mortality in patients undergoing major emergency abdominal surgery due a poor calibration.

OriginalsprogEngelsk
Sider (fra-til)1721-1727
Antal sider7
TidsskriftEuropean Journal of Trauma and Emergency Surgery
Vol/bind47
Udgave nummer6
Tidlig onlinedato3 jun. 2019
DOI
StatusUdgivet - dec. 2021

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© 2019. Springer-Verlag GmbH Germany, part of Springer Nature.

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