ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025
Validation of the emergency surgery score's predictive accuracy for postoperative outcomes and ICU admissions in MENA vs. non-MENA emergency surgery patients.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Emergency surgery score as a predictor of postoperative surgical site infection in patients undergoing emergency surgery for gastrointestinal diseases: A prospective cohort study.Pakistan journal of medical sciences · 2026Article
- Perioperative predictors of critical care admission following emergency surgical procedures: a comprehensive evaluation of anesthesia management.Perioperative medicine (London, England) · 2026Article
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Abstract
backgroundThe Emergency Surgery Score (ESS) has demonstrated strong predictive value for morbidity, mortality, and long-term survival outcomes. However, its applicability and validity in the Middle East and North Africa (MENA) region remain understudied. This research seeks to validate ESS's ability to predict postoperative outcomes, including 30-day mortality, complications, and ICU admissions, among patients undergoing emergency laparotomies (EL).
methodsThis retrospective study analyzed 230 EL cases from 2017 to 2021. ESS scores were calculated for each patient, and its predictive accuracy was compared with the American Society of Anesthesiologists (ASA) classification using c-statistic methodology. We also compared postoperative outcomes between MENA and non-MENA cohorts to assess potential regional variations in ESS performance.
resultsOut of 230 patients, 118 were from MENA and 112 from non-MENA regions. Sepsis was the most common diagnosis (69.6%). ICU admission was recorded in 63.4% of cases, and the 30-day mortality rate was 13.91%. ESS scores did not differ significantly between MENA and non-MENA patients (median: 7.5 vs. 7; P = 0.45). ESS outperformed ASA in predicting postoperative outcomes: complications (c-statistic: 0.79 vs. 0.73), ICU admissions (0.81 vs. 0.76), and mortality (0.86 vs. 0.78). Optimal ESS cutoffs for complications, ICU need, and mortality were 6, 8, and 10, respectively. ESS performed similarly across both MENA and non-MENA populations in predicting mortality, complications, and ICU admissions.
conclusionThe ESS is a superior tool compared to ASA for predicting postoperative outcomes in emergency surgical patients, and it is applicable to diverse populations, including those from the MENA region. ESS enhances preoperative risk stratification, informs counseling decisions, and supports quality benchmarking across different healthcare settings. Future studies should address potential biases, including selection and information bias, and further explore ESS's role in different cultural contexts.
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