Physiologic Modification of the American Society of Anaesthesiology Score (ASA) for Prediction of Morbidity and Mortality after Emergency Laparotomy

Background and aims:Laparotomy is commonly performed as an emergency operation. It is often performed on elderly patients with high risks of mortality and morbidity. Currently there is no accurate scoring system to predict preoperatively mortality and morbidity in these circumstances. This study was conducted to develop a scoring system that can accurately predict the risk of in-hospital mortality and complications for these patients in the emergency department prior to surgery. Patients and methods:Middlemore Hospital data were searched for patients who underwent emergency laparotomy for an acute abdominal condition between January 1997 and December 2006. Data collected included age, gender, presenting diagnosis, indications for surgery, acute physiological parameters and also data on associated comorbidities. We categorized patients for the risk of morbidity and 30-day mortality. The risk categorization was based on preoperative existing comorbidities and acute