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A Proposed New Mortality Prediction Tool For Emergency Laparotomy (NMPT)

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A Proposed New Mortality Prediction Tool For Emergency Laparotomy (NMPT)
S Mohamed (1), R Khoju (2), Z Sallami (1), T Atcha (1)
(1) Department of Surgery, Bronglais General Hospital, Aberystwyth, Wales, UK
(2) Department of Anaesthesia, Bronglais General Hospital, Aberystwyth, Wales, UK

INTRODUCTION
• 2nd Patient Report of NELA reported that the estimate of risk of
death provided by P-POSSUM tends to overestimate risk above
15%
AIM
Try to find a more accurate peri-operative risk stratification tool to
predict 30-day mortality for those with P-POSSUM expected
mortality of more than 15%.
METHODS
Data collection and Development of the tool:
 Our local emergency laparotomy data from December 2013 to
November 2015 were retrieved from NELA database.
 These data were used to calculate the Surgical Outcome Risk Tool
(SORT) for each patient using NCEPOD Application.
 We developed a new mortality prediction tool (NMPT) by calculating
the average of SORT and post-operative P-POSSUM for each patient.
 We compared the performance of these tools; NMPT, SORT, pre-and
post-operative P-POSSUM with respect to discrimination and calibration.
 The new tool NMPT was validated in patients whose P-POSSUM
expected mortality is more than 15%.
Data Analysis:
 Stata was used for
 ROC curves and AUROC calculation to evaluate discrimination and
 Estimate the P value for the Hosmer–Lemeshow χ2 test and calibration
curves
CONCLUSIONS
• This proposed new mortality prediction tool (NMPT) has a good
discrimination and calibration.
• It is better calibrated in patients with P-POSSUM expected mortality
more than 15%.
• Giving the limitation of a small cohort, further studies are required to
assess its performance in larger cohort of patients

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