• Chrysanthos Dimitris Christou, Leon Naar, Napaporn Kongkaewpaisan, Alexandros Tsolakidis, Panagiotis Smyrnis, Andreas Tooulias, Georgios Tsoulfas, Vasileios Nikolaos Papadopoulos, George Constantinos Velmahos, and Haytham Mohamed Ali Kaafarani.
• First General Surgery Department, School of Medicine, Faculty of Medical Sciences, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
• Eur J Trauma Emerg Surg. 2022 Apr 1; 48 (2): 1197-1204.

PurposeThe Emergency Surgery Score (ESS) is a reliable point-based score that predicts mortality and morbidity in emergency surgery patients. However, it has been validated only in the U.S.PatientsWe aimed to prospectively validate ESS in a Greek patient population.MethodsAll patients who underwent an emergent laparotomy were prospectively included over a 15-month period. A systematic chart review was performed to collect relevant preoperative, intraoperative, and postoperative variables based on which the ESS was calculated for each patient. The relationship between ESS and 30-day mortality, morbidity (i.e., the occurrence of at least one complication), and the need for intensive care unit (ICU) admission was evaluated and compared between the Greek and U.S. patients using the c-statistics methodology. The study was registered on "Research Registry" with the unique identifying number 5901.ResultsA total of 214 patients (102 Greek) were included. The mean age was 64 years, 44% were female, and the median ESS was 7. The most common indication for surgery was hollow viscus perforation (25%). The ESS reliably and incrementally predicted mortality (c-statistics = 0.79 [95% CI 0.67-0.90] and 0.83 [95% CI 0.74-0.92]), morbidity (c-statistics = 0.83 [95% CI 0.76-0.91] and 0.79 [95% CI 0.69-0.88]), and ICU admission (c-statistics = 0.88 [95% CI 0.81-0.96] and 0.84 [95% CI 0.77-0.91]) in both Greek and U.S.PatientsConclusionThe correlation between the ESS and the surgical outcomes was statistically significant in both Greek and U.S. patients undergoing emergency laparotomy. ESS could prove globally useful for preoperative patient counseling and quality-of-care benchmarking.© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.

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