External validation of HAS model in predicting mortality after emergency laparotomy: a retrospective cohort study.

IF 1.1 4区医学 Q3 SURGERY

Annals of the Royal College of Surgeons of England Pub Date : 2025-04-03 DOI:10.1308/rcsann.2025.0021

H Soliman, C Smith, J Mena, G T Yusuf, A H Helmy

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引用次数: 0

Abstract

Introduction: We aimed to externally validate the performance of the HAS model (Hajibandeh Index, American Society of Anaesthesiologists status, and sarcopenia) in predicting mortality after emergency laparotomy. We also aimed to compare the HAS model with the Parsimonious NELA (National Emergency Laparotomy Audit) risk score.

Methods: In this retrospective cohort study, we included adult patients who underwent emergency laparotomy between January 2022 and June 2023. The performance of the HAS score and the NELA score in predicting 30-day mortality was compared using receiver operating characteristic (ROC) curve analysis. We performed subgroup analysis for the following age groups: age ≥50, age ≥60, age ≥70, and age ≥80 years.

Findings: We included 117 patients in this study. ROC curve analysis showed that area under the curve (AUC) of the HAS score for 30-day mortality was 0.90 (95% CI 0.83-0.95). Although the AUC of HAS score was higher than the AUC of NELA score for all patients, this was not statistically significant (0.90 vs 0.80, p=0.097). AUC of the HAS score was superior to NELA score in patients aged ≥50 (0.89 vs 0.75, p=0.040), patients aged ≥60 (0.87 vs 0.69, p=0.020), patients aged ≥70 (0.85 vs 0.67, p=0.030), and patients aged ≥80 (0.90 vs 0.66, p<0.001).

Conclusions: The results of the current study support the external validity of the HAS model in predicting 30-day mortality after emergency laparotomy. Prospective studies with larger sample size are required.

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HAS模型预测急诊剖腹手术后死亡率的外部验证：一项回顾性队列研究

前言：我们旨在从外部验证HAS模型（Hajibandeh指数、美国麻醉师协会地位和肌肉减少症）在预测急诊剖腹手术后死亡率方面的性能。我们还旨在比较HAS模型与简约的NELA（国家紧急剖腹手术审计）风险评分。方法：在这项回顾性队列研究中，我们纳入了2022年1月至2023年6月期间接受紧急剖腹手术的成年患者。采用受试者工作特征（ROC）曲线分析比较HAS评分和NELA评分预测30天死亡率的效果。我们对以下年龄组进行亚组分析：年龄≥50岁、年龄≥60岁、年龄≥70岁和年龄≥80岁。结果：我们纳入了117例患者。ROC曲线分析显示，HAS评分对30天死亡率的曲线下面积（AUC）为0.90 （95% CI 0.83-0.95）。虽然所有患者HAS评分的AUC均高于NELA评分的AUC，但差异无统计学意义（0.90 vs 0.80, p=0.097）。在≥50岁（0.89 vs 0.75, p=0.040）、≥60岁（0.87 vs 0.69, p=0.020）、≥70岁（0.85 vs 0.67, p=0.030）和≥80岁（0.90 vs 0.66, p）患者中，HAS评分的AUC优于NELA评分。结论：本研究结果支持HAS模型预测急诊剖腹手术后30天死亡率的外部有效性。需要更大样本量的前瞻性研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of the Royal College of Surgeons of England Medicine-Surgery

CiteScore

2.40

自引率

0.00%

发文量

316

期刊介绍： The Annals of The Royal College of Surgeons of England is the official scholarly research journal of the Royal College of Surgeons and is published eight times a year in January, February, March, April, May, July, September and November. The main aim of the journal is to publish high-quality, peer-reviewed papers that relate to all branches of surgery. The Annals also includes letters and comments, a regular technical section, controversial topics, CORESS feedback and book reviews. The editorial board is composed of experts from all the surgical specialties.