TPT 3.01 Correlation Between Observed Mortality and SORT-Predicted 30-Day Mortality Following the Five Most Common Emergency Laparotomy Procedures in Romania: A Retrospective Multicentre Observational Cohort Study

Q: What are the key findings of this study?

The Surgical-Outcome-Risk-Tool (SORT) demonstrated limited reliability and persistent misprediction of 30-day mortality across the five most common emergency laparotomy procedures in Romania.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Emergency laparotomy (n=793). Intervention: Surgical-Outcome-Risk-Tool (SORT) vs. Observed 30-day mortality. Primary outcome: Correlation between actual and SORT-predicted 30-day mortality for the 5 most common emergency laparotomy procedures.

Q: What does this research mean for the field?

The Surgical Outcome Risk Tool (SORT) exhibits weak correlation and persistent misprediction of 30-day mortality across the most common emergency laparotomy procedures in Romania. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Gabriel Andi Iordache; Sergiu Timofeiov; Daniela Jardan; Radu Florin Popa; Viorel Scripcariu; Andrei Moscalu

doi:10.1093/bjs/znag087.184

August 1, 2026British journal of surgeryOpen Access

TPT 3.01 Correlation Between Observed Mortality and SORT-Predicted 30-Day Mortality Following the Five Most Common Emergency Laparotomy Procedures in Romania: A Retrospective Multicentre Observational Cohort Study

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Key result

SORT reliably mispredicts 30-day mortality across common emergency laparotomy procedures.

n=793

Why the study?

Procedure-specific 30-day mortality outcomes following emergency laparotomy are limited, and the correlation with SORT-predicted mortality is unclear.

Does the Surgical-Outcome-Risk-Tool (SORT) accurately predict 30-day mortality in adults undergoing common emergency laparotomy procedures?

Key Points

To determine the actual 30-day mortality for the five most common emergency laparotomy procedures in Romania and evaluate its correlation with Surgical Outcome Risk Tool (SORT) predictions.
Retrospective multicentre observational cohort study adhering to TRIPOD guidelines across four acute care hospitals, including one tertiary center, in North-Eastern Romania.
Included 793 adult emergency laparotomy patients over two years, focusing analysis on the 448 patients (56.4%) undergoing the five most common interventions.
Analyzed the correlation and predictive performance between observed 30-day mortality and median SORT scores using GraphPad Prism v10.6.1.
Incisional hernia repair with adhesiolysis (n=100) had actual mortality of 4.0% versus SORT 3.8% (IQR 1.7–11.2; R²=0.33, AUC=0.9648, p<0.0001); inguinal hernia repair with adhesiolysis (n=65) had actual mortality of 1.5% versus SORT 3.21% (IQR 0.9–8.2; R²=0.13, p=0.0001).
SORT markedly underpredicted mortality in adhesiolysis alone (n=107; actual 15.9% vs SORT 6.86% [IQR 3.1–14.0], R²=0.05, AUC=0.7497, p=0.0117) and suture of perforated peptic ulcer (n=88; actual 20.5% vs SORT 5.78% [IQR 1.4–14.0], R²=0.24, AUC=0.8516, p<0.0001).
Hartmann's procedure (n=88) had actual 30-day mortality of 21.6% compared to a median SORT prediction of 23.06% (IQR 12.1–40.3; R²=0.16, AUC=0.7645, p=0.0001).

Study Design

Type

Cohort (n=793)

Multicenter

Yes

Structured PICO

Does the Surgical-Outcome-Risk-Tool (SORT) accurately predict 30-day mortality in adults undergoing common emergency laparotomy procedures?

P

Population

793 adults undergoing emergency laparotomy across four acute care hospitals in North-Eastern Romania over a two-year period.

E

Exposure

Surgical-Outcome-Risk-Tool (SORT) predicted mortality

O

Outcome

Correlation between actual and SORT predicted 30-day mortality for the 5 most common EL procedures

The SORT risk prediction tool demonstrated weak correlation and limited reliability for predicting 30-day mortality following common emergency laparotomy procedures in a Romanian cohort.

Implication

Observed mortality matches SORT in hernia repair; leaves open recalibration needs for higher-risk emergency procedures.

Abstract

Background Emergency laparotomy (EL) comprises heterogeneous high-risk procedures with substantial postoperative mortality, reaching 8–18% at 30 days. Although overall 30-day mortality (30-dm) is documented, procedure-specific outcomes remain limited. Defining intervention-level mortality may improve risk stratification and resource allocation. This study aimed to quantify actual 30-dm for the five most frequently performed EL procedures in Romania and examine its correlation with Surgical-Outcome-Risk-Tool (SORT) predicted mortality. Methods This retrospective multicentre cohort study included adults undergoing EL over two years across four acute care hospitals in North-Eastern Romania, including one tertiary centre. The primary outcome was the correlation between actual and SORT predicted 30-dm for the 5 most common EL procedures. The study followed the TRIPOD checklist. Statistical analysis was performed using GraphPad-Prism v10.6.1. Results Among 793 EL patients, 448 (56.4%) underwent the five most frequent procedures: incisional hernia repair with adhesiolysis (n=100;12.61%); actual 30-dm 4.0%; SORT 3.8% (1.7,11.2); R²=0.33, AUC=0.9648, p<0.0001; adhesiolysis (n=107;13.495); actual 30-dm 15.9%; SORT 6.86% (3.1,14.0); R²=0.05, AUC=0.7497, p=0.0117; suture of perforated peptic ulcer (n=88;11.09%), actual 30-dm 20.5%; SORT 5.78% (1.4,14.0); R²=0.24, AUC=0.8516, p<0.0001; Hartmann’s procedure (n=88;11.09%), actual 30-dm 21.6%; SORT 23.06% (12.1,40.3); R²=0.16, AUC=0.7645, p=0.0001; and inguinal hernia repair with adhesiolysis (n=65;8.19%) actual 30-dm mortality 1.5%; SORT 3.21% (0.9,8.2); R²=0.13, p=0.0001. Data is presented as median ± IQR. Conclusion SORT demonstrated limited reliability, weak correlation, and persistent misprediction of 30-day mortality across the five most common emergency laparotomy procedures in Romania.

Discussion

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Cite This Study

Iordache et al. (2026) conducted a cohort in Emergency laparotomy (n=793). Surgical-Outcome-Risk-Tool (SORT) vs. Observed 30-day mortality was evaluated on Correlation between actual and SORT-predicted 30-day mortality for the 5 most common emergency laparotomy procedures. The Surgical-Outcome-Risk-Tool (SORT) demonstrated limited reliability and persistent misprediction of 30-day mortality across the five most common emergency laparotomy procedures in Romania.

synapsesocial.com/papers/6ad0fc8615427f6a840401d3 https://doi.org/10.1093/bjs/znag087.184

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TPT 3.01 Correlation Between Observed Mortality and SORT-Predicted 30-Day Mortality Following the Five Most Common Emergency Laparotomy Procedures in Romania: A Retrospective Multicentre Observational Cohort Study

Key Points

Study Design

Structured PICO

Implication

Abstract

Discussion

Cite This Study

TPT 3.01 Correlation Between Observed Mortality and SORT-Predicted 30-Day Mortality Following the Five Most Common Emergency Laparotomy Procedures in Romania: A Retrospective Multicentre Observational Cohort Study

Key Points

Study Design

Structured PICO

Implication

Abstract

Discussion

Cite This Study

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