Key result
In 419 adults undergoing emergency general surgery, the SHARP risk score was associated with higher odds of 90-day mortality and increased length of hospital stay.
Why the study?
Few studies have described risks of poor outcomes based on admission information to predict adults with increased risk of poor outcomes in the acute surgical setting.
Does the SHARP risk score predict 90-day mortality and poor outcomes in adult patients admitted for emergency general surgery?
Cohort (n=419)
Yes
Does the SHARP risk score predict 90-day mortality and poor outcomes in adult patients admitted for emergency general surgery?
The SHARP risk score is a simple, point-of-care prognostic tool that can predict 90-day mortality and prolonged hospital stay in adults undergoing emergency general surgery.
May support risk stratification in emergency surgery; hypothesis-generating and requires prospective validation before adoption.
PURPOSE: Post-operative complications following emergency abdominal surgery are associated with significant morbidity and mortality. Despite the knowledge of prognostic factors associated with poor surgical outcomes; few have described risks of poor outcomes based on admission information in acute surgical setting. We aimed to derive a simple, point-of-care risk scale that predicts adults with increased risk of poor outcomes. METHODS: We used data from an international multi-centre prospective cohort study. The effect of characteristics; age, hypoalbuminaemia, anaemia, renal insufficiency and polypharmacy on 90-day mortality was examined using fully adjusted multivariable models. For our secondary outcome we aimed to test whether these characteristics could be combined to predict poor outcomes in adults undergoing emergency general surgery. Subsequently, the impact of incremental increase in derived SHARP score on outcomes was assessed. RESULTS: The cohort consisted of 419 adult patients between the ages of 16-94 years (median 52; IQR(39) consecutively admitted to five emergency general surgical units across the United Kingdom and one in Ghent, Belgium. In fully adjusted models the aforementioned characteristics; were associated with 90-day mortality. SHARP score was associated with higher odds of mortality in adults who underwent emergency general surgery, with a SHARP score of five also being associated with an increased length of hospital stay. CONCLUSIONS: SHARP risk score is a simple prognostic tool, using point-of-care information to predict poor outcomes in patients undergoing emergency general surgery. This information may be used to improve management plans and aid clinicians in delivering more person-centred care. Further validation studies are required to prove its utility.
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Tanos et al. (2022) conducted a cohort in emergency general surgery (n=419). SHARP risk score was evaluated on 90-day mortality. In 419 adults undergoing emergency general surgery, the SHARP risk score was associated with higher odds of 90-day mortality and increased length of hospital stay.
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