194 ORIEL (Mortality Risk Prediction in Emergency Laparotomy): A Comparison of Mortality Risk Prediction Tools

Abstract Aim Emergency laparotomies carry significant risk of morbidity and mortality. Risk calculation tools are essential to identify high-risk patients inform clinicians in decision making. As part a multi-centre research initiative, retrospective study all emergency major trauma centre was conducted determine the most accurate predictor thirty-day mortality by comparing four, internationally recognised, assessment tools. Method Patients who underwent laparotomy were identified using hospital databases. National Laparotomy Audit (NELA) used record pre- post-operative scores. The Portsmouth Physiological Operative Severity Score for enumeration Mortality Morbidity (P-POSSUM); American College Surgeons Surgical Quality Improvement Program (ACS-NSQIP) Outcome Tool (SORT) calculate each patient. Receiver Operating Curve (ROC) statistical method chosen compare results order establish tool pertinent prediction local Results 274 at Trust between December 2017 2019. Of these, 96.7% (n=265) survived 30-day post -operative period 3.3% (n= 9) died. ROC comparator demonstrated 100% sensitivity NELA, P-POSSUM ACS-NSQIP specificity 77%, 76% 63% respectively. SORT found be poorest indicator Conclusions NELA is undergo laparotomy. Comparison with outcomes other centres will help confirm our results.