Key result
The NELA score showed better discrimination for predicting mortality (C-index 0.818; 95% CI 0.769-0.867) than the P-POSSUM score (C-index 0.769), though NELA under-predicted observed mortality.
Why the study?
Preoperative mortality risk assessment is crucial in emergency laparotomy, but no direct comparison existed between the widely used P-POSSUM score and the novel NELA score.
Does the NELA score predict mortality better than the P-POSSUM score in patients undergoing emergency laparotomy?
Population
650 patients undergoing emergency laparotomy
Comparison
NELA score vs P-POSSUM score
Design
Database analysis
Authors
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May support NELA over P-POSSUM for mortality risk stratification in emergency laparotomy; leaves open need for recalibration and prospective validation.
Cohort (n=650)
Yes
Does the NELA score predict mortality better than the P-POSSUM score in patients undergoing emergency laparotomy?
Effect estimate: C-index 0.818 (95% CI 0.769-0.867)
Absolute Event Rate: 0.818% vs 0.769%
p-value: p=<0.001
The NELA score demonstrates better discrimination than the P-POSSUM score for predicting mortality in patients undergoing emergency laparotomy, although NELA under-predicts and P-POSSUM over-predicts observed mortality.
Thahir et al. (2020) conducted a cohort in Emergency laparotomy (n=650). NELA score vs. P-POSSUM score was evaluated on Mortality (discriminative power) (C-index 0.818, 95% CI 0.769-0.867, p=<0.001). The NELA score showed better discrimination for predicting mortality (C-index 0.818; 95% CI 0.769-0.867) than the P-POSSUM score (C-index 0.769), though NELA under-predicted observed mortality.
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