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Description

Cordoba et al reported the USEM formula for predicting mortality in an elderly patient undergoing urgent surgery. The authors are from multiple institutions in Navarra, Spain.


Patient selection: urgent surgery in a patient > 65 years of age

 

Parameters:

(1) age in years

(2) diagnosis

(3) ASA score

(4) surgical wound classification

(5) type of surgery

 

Parameter

Finding

Points

age

 

(years) * 0.036

diagnosis

acute appendicitis

0

 

soft tissue abscess

0.037

 

acute cholecystitis

0.5

 

intra-abdominal abscess

0.531

 

incarcerated hernia

0.988

 

complicated peptic ulcer

1.113

 

colorectal obstruction

1.625

 

colorectal perforation

1.646

 

intestinal obstruction

1.907

 

polytrauma

2.048

 

lower GI bleeding

2.117

 

hepato/biliary/pancreatic

2.345

 

intestinal ischemia

3.633

 

other

2.089

ASA score

ASA I

0

 

ASA II

0.545

 

ASA III

1.317

 

ASA IV

2.263

 

ASA V

3.14

wound classification

clean or clean-contaminated

0

 

contaminated

0.469

 

dirty or infected

0.911

surgery

laparoscopic

0

 

open

0.953

 

value of X =

= SUM(points for all of the parameters) - 9.32

 

mortality risk =

= 1 / (1 + EXP((-1) * X))

 

Performance:

• The area under the ROC curve is 0.84.


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