{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T01:46:18Z","timestamp":1793670378693,"version":"4.5.1"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T00:00:00Z","timestamp":1687478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Risk prediction models are frequently used to identify high\u2010risk patients undergoing emergency laparotomy. The National Emergency Laparotomy Audit (NELA) developed a risk prediction model specifically for emergency laparotomy patients, which was recently updated. In this study, we validated the updated NELA model in an external population. Furthermore, we compared it with three other risk prediction models: the original NELA model, the Portsmouth Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (P\u2010POSSUM) model, and the American Society of Anesthesiologists Physical Status (ASA\u2010PS). We included adult patients undergoing emergency laparotomy at Zealand University Hospital, from March 2017 to January 2019, and Herlev Hospital, from November 2017 to January 2020. Variables included in the risk prediction models were collected retrospectively from the electronic patient records. Discrimination of the risk prediction models was evaluated with area under the curve (AUC) statistics, and calibration was assessed with Cox calibration regression. The primary outcome was 30\u2010day mortality. Out of 1226 included patients, 146 patients (11.9%) died within 30\u2009days. AUC (95% confidence interval) for 30\u2010day mortality was 0.85 (0.82\u20130.88) for the updated NELA model, 0.84 (0.81\u20130.87) for the original NELA model, 0.81 (0.77\u20130.84) for the P\u2010POSSUM model, and 0.76 (0.72\u20130.79) for the ASA\u2010PS model. Calibration showed underestimation of mortality risk for both the updated NELA, original NELA and P\u2010POSSUM models. The updated NELA risk prediction model performs well in this external validation study and may be used in similar settings. However, the model should only be used to discriminate between low\u2010 and high\u2010risk patients, and not for prediction of individual risk due to underestimation of mortality.<\/jats:p>","DOI":"10.1111\/aas.14294","type":"journal-article","created":{"date-parts":[[2023,6,25]],"date-time":"2023-06-25T01:18:29Z","timestamp":1687655909000},"page":"1194-1201","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Validation of the <scp>NELA<\/scp> risk prediction model in emergency abdominal surgery"],"prefix":"10.1111","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5189-4273","authenticated-orcid":false,"given":"Anna K.","family":"Hansted","sequence":"first","affiliation":[{"name":"Herlev Anaesthesia Critical and Emergency Care Science Unit (ACES), Department of Anaesthesiology Copenhagen University Hospital\u2010Herlev Hospital  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Storm","sequence":"additional","affiliation":[{"name":"Department of Surgery Copenhagen University Hospital\u2010Herlev Hospital  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob","family":"Burcharth","sequence":"additional","affiliation":[{"name":"Department of Surgery Copenhagen University Hospital\u2010Herlev Hospital  Copenhagen Denmark"},{"name":"Department of Surgery, Zealand University Hospital University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pernille D. K.","family":"Diasso","sequence":"additional","affiliation":[{"name":"Department of Surgery, Zealand University Hospital University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mian","family":"Ninh","sequence":"additional","affiliation":[{"name":"Herlev Anaesthesia Critical and Emergency Care Science Unit (ACES), Department of Anaesthesiology Copenhagen University Hospital\u2010Herlev Hospital  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6378-9673","authenticated-orcid":false,"given":"Morten H.","family":"M\u00f8ller","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine University of Copenhagen  Copenhagen Denmark"},{"name":"Department of Intensive Care 4131 Copenhagen University Hospital\u2010Rigshospitalet  Copenhagen 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