The validity of emergency surgery score in predicting mortality and complications in general surgical emergencies.

Background: Patients who need emergency general surgery (EGS) face an increase in 30-day mortality and complicationrates that can be anticipated by emergency surgery score (ESS).Aim: The study aimed to measure the validity and efficacy of ESS application on EGS patients admitted at Beni-SuefUniversity Hospital to calculate the rates of postoperative mortality, complications, reoperation, and ICU admission.Patients and Methods: This was a retrospective validation study. The study included 200 patients (older adults andelderly) who were admitted to the general surgery ward for EGS from September 1, 2023 to March 1 2024. The primaryoutcome was measuring the 30-day mortality rate. However, the secondary outcomes were measuring the occurrence of at least one complication, reoperation, and ICU admission rates. Admitted comorbidities, as well as preoperative laboratory tests, were collected. Surgical outcomes were predicted for patients using ESS calculation. Postoperative outcomes were tracked from the day of surgery to 30 days.Results: Among patients admitted, total prevalence of 30-day mortality was nine (4.5%), while 30-day complications ratewas 27%. There was a significant increase (P<0.001) in mortality due to the increase of ESS with an area under the curve(AUC) NELA score (0.846) and confidence interval (CI) (95% CI: 0.717–0.976), and AUC P-POSSUM score of 0.811and CI (95% CI: 0.734–0.972) with no significant difference between the two scores (P=0.369), and AUC P-POSSUMscore of 0.811 and CI (95% CI: 0.734–0.972) with no significant difference between the two scores (P=0.369). There wasa significant increase (P<0.001) in the prediction of at least one complication due to the increase of ESS with an AUCNELA score (0.919) and CI (95% CI: 0.88–0.957) and AUC P-POSSUM score (0.927) and CI (95% CI: 0.82–0.945), withno significant difference between the two scores (P=0.269). There was a significant increase in ICU readmission due tothe increase of ESS (P<0.001) with an AUC (0.785) and CI (95% CI: 0.678–0.892).Conclusion: ESS is a golden key in predicting mortality, complications, and ICU admission among elderly patients whounderwent EGS and can be used for frontline decision-making, family and patient guidance, resource allocation, andquality monitoring of elderly surgical care.