{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T18:45:58Z","timestamp":1788201958979,"version":"build-2803163510"},"reference-count":18,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T00:00:00Z","timestamp":1689292800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>The probability of death after emergency laparotomy varies greatly between patients. Accurate pre\u2010operative risk prediction is fundamental to planning care and improving outcomes. We aimed to develop a model limited to a few pre\u2010operative factors that performed well irrespective of surgical indication: obstruction; sepsis; ischaemia; bleeding; and other. We derived a model with data from the National Emergency Laparotomy Audit for patients who had emergency laparotomy between December 2016 and November 2018. We tested the model on patients who underwent emergency laparotomy between December 2018 and November 2019. There were 4077\/40,816 (10%) deaths 30\u2009days after surgery in the derivation cohort. The final model had 13 pre\u2010operative variables: surgical indication; age; blood pressure; heart rate; respiratory history; urgency; biochemical markers; anticipated malignancy; anticipated peritoneal soiling; and ASA physical status. The predicted mortality probability deciles ranged from 0.1% to 47%. There were 1888\/11,187 deaths in the test cohort. The scaled Brier score, integrated calibration index and concordance for the model were 20%, 0.006 and 0.86, respectively. Model metrics were similar for the five surgical indications. In conclusion, we think that this prognostic model is suitable to support decision\u2010making before emergency laparotomy as well as for risk adjustment for comparing organisations.<\/jats:p>","DOI":"10.1111\/anae.16096","type":"journal-article","created":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T12:03:21Z","timestamp":1689336201000},"page":"1262-1271","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Development and validation of a prognostic model for death 30\u2009days after adult emergency laparotomy"],"prefix":"10.1111","volume":"78","author":[{"given":"N.","family":"Eugene","sequence":"first","affiliation":[{"name":"Clinical Effectiveness Unit Royal College of Surgeons of England  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Kuryba","sequence":"additional","affiliation":[{"name":"Clinical Effectiveness Unit Royal College of Surgeons of England  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Applied Health Research University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. M.","family":"Oliver","sequence":"additional","affiliation":[{"name":"UCL Division of Surgery and Interventional Science University College London Hospitals NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Berry","sequence":"additional","affiliation":[{"name":"Critical Care King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I. K.","family":"Moppett","sequence":"additional","affiliation":[{"name":"Anaesthesia and Critical Care Section, Academic Unit of Injury, Inflammation and Repair University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Johnston","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia St George's Hospital  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Hare","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Medway Maritime Hospital  Gillingham Kent UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Lockwood","sequence":"additional","affiliation":[{"name":"Colorectal Surgery Department Bradford Teaching Hospitals NHS Foundation Trust  Bradford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Murray","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia James Cook University Hospital  Middlesbrough UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Health Services Research and Policy London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. A.","family":"Cromwell","sequence":"additional","affiliation":[{"name":"Department of Health Services Research and Policy London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the NELA Project Team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,14]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2018.06.026"},{"key":"e_1_2_6_3_1","unstructured":"Royal College of Surgeons of England.The High\u2010Risk General Surgical Patient: Raising the Standard. 2018.https:\/\/www.rcseng.ac.uk\/\u2010\/media\/files\/rcs\/news\u2010and\u2010events\/media\u2010centre\/2018\u2010press\u2010releases\u2010documents\/rcs\u2010report\u2010the\u2010highrisk\u2010general\u2010surgical\u2010patient\u2010\u2010raising\u2010the\u2010standard\u2010\u2010december\u20102018.pdf(accessed 26\/06\/2023)."},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9696"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4430"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.2478\/pjs-2014-0029"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.4274"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9638"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/bimj.201400004"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9876.00155"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1422"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aev350"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/9780470770771"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e3181c30fb2"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X06295361"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.8281"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(01)00341-9"},{"key":"e_1_2_6_18_1","first-page":"70","article-title":"Highlighting uncertainty in clinical risk prediction using a model of emergency laparotomy mortality risk","volume":"5","author":"Mathiszig\u2010Lee JF","year":"2022","journal-title":"Nature Portfolio Journal Digital Medicine"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003402"}],"container-title":["Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.16096","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T18:07:30Z","timestamp":1761674850000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1111\/anae.16096"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,14]]},"references-count":18,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1111\/anae.16096"],"URL":"https:\/\/doi.org\/10.1111\/anae.16096","archive":["Portico"],"relation":{},"ISSN":["0003-2409","1365-2044"],"issn-type":[{"value":"0003-2409","type":"print"},{"value":"1365-2044","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,14]]},"assertion":[{"value":"2023-06-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}