Development and validation of a preoperative prediction model for geriatric emergency general surgery

Abstract

Purpose: The aim of this study was to establish a scoring system for preoperative assessment of postoperative mortality in elderly patients undergoing emergency general surgery. Methods: A retrospectively database of geriatric emergency general surgery (EGS) patients who underwent emergency surgery was used for the development of the scoring system. Results: In total, 1500 patients were enrolled with mean age of 69.8 years in the study. Through the development and comparison of models, we ultimately derived a rating scale known as GES (Geriatric Emergency Surgery Score). This score has a c-statistic of 0.892 for mortality (95% CI 0.854–0.931). The observed probability of mortality in hospital gradually increased from 1.1% at a score of 0 to 30.3% at a score of 5 and 100% at a score of 8. Conclusion: The GES scoring model in this study will accurately predict the mortality risk of elderly patients with acute abdomen, optimize the allocation of medical resources, and standardize the assessment of patients' conditions based on scientific criteria. Further prospective multicenter trials are needed to externally validate the model developed.