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  • Title: Derivation and Validation of a Novel Physiological Emergency Surgery Acuity Score (PESAS).
    Author: Sangji NF, Bohnen JD, Ramly EP, Velmahos GC, Chang DC, Kaafarani HMA.
    Journal: World J Surg; 2017 Jul; 41(7):1782-1789. PubMed ID: 28233063.
    Abstract:
    BACKGROUND: We present a novel and abbreviated Physiological Emergency Surgery Acuity Score (PESAS) that assesses the severity of disease at presentation in patients undergoing Emergency Surgery (ES). METHODS: Using the 2011 ACS-NSQIP database, we identified all patients who underwent "emergent" surgery. The following methodology was designed: (1) identification of independent predictors of 30-day mortality that are markers of acuity; (2) derivation of PESAS based on the relative impact (i.e., odds ratio) of each predictor; and (3) measurement of the c-statistic. The PESAS was validated using the 2012 ACS-NSQIP database. RESULTS: From 24,702 ES cases, a 15-point score was derived. This included 10 components with a range of 0 and 15 points. Its c-statistic was 0.80. Mortality gradually increased from 1.7 to 40.6 to 100% at scores of 0, 8, and 15, respectively. In the validation phase, PESAS c-statistic remained stable. CONCLUSION: PESAS is a novel score that assesses the acuity of disease at presentation in ES patients and strongly correlates with postoperative mortality risk. PESAS could prove useful for preoperative counseling and for risk-adjusted benchmarking.
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