Emergency Surgery Mortality (ESM) Score to Predict Mortality and Improve Patient Care in Emergency Surgery
Table 2
Patient demographic and clinical data of the Training group (n = 596).
Parameter
Nonsurvivors (n = 84)
Survivors (n = 512)
value
General data
Age (yr)
52.1 ± 20.3
59.9 ± 18.2
<0.001
Sex
Male
54 (64.3)
306 (59.8)
0.471
Body weight (kg)
62.9 ± 12.5
59.8 ± 1.2
0.108
Height (m)
1.6 ± 0.1
1.6 ± 0.1
0.074
BMI (kg/m2)
24.1 ± 4.6
23.3 ± 11.4
0.260
ASA class
<0.001
2E
2 (2.4)
21 (4.1)
3E
11 (13.1)
58 (11.3)
4E
37 (44.0)
409 (79.9)
5E
34 (40.5)
24 (4.7)
On endotracheal tube
41 (48.8)
131 (25.6)
<0.001
Heart rate (beats/min)
109.4 ± 28.2
94.9 ± 21.8
<0.001
Systolic blood pressure (mmHg)
103.4 ± 33.9
125.2 ± 24.5
<0.001
Diastolic blood pressure (mmHg)
59.4 ± 19.1
71.4 ± 15.0
<0.001
Temperature (°C)
37.2 ± 0.7
38.2 ± 11.5
0.459
Oxygen saturation (%)
93.2 ± 10.7
98.3 ± 4.8
<0.001
Smoking
11 (13.1)
56 (10.9)
0.575
Previous anesthesia
34 (40.5)
235 (45.9)
0.629
Duration of anesthesia (min)
123.0 ± 82.3
123.2 ± 78.5
0.974
Type of surgery
0.440
General
42 (50)
220 (43.0)
Cardiovascular and thoracic
5 (6.0)
51 (9.9)
Neurologic
14 (16.6)
124 (24.2)
Plastic
3 (3.6)
16 (3.1)
Urologic
5 (6.0)
28 (5.5)
Orthopedic
6 (7.1)
20 (3.9)
Otorhinolaryngologic
4 (4.7)
25 (4.9)
Gynecologic
3 (3.6)
19 (3.7)
Medical
2 (2.4)
9 (1.8)
Comorbidity
Infection
23 (27.3)
96 (18.7)
0.037
Bleeding
27 (32.1)
51 (10.0)
<0.001
Hypertension with cardiovascular sequelae
3 (3.6)
28 (5.5)
0.405
Cardiovascular system
8 (9.5)
74 (14.5)
0.220
Respiratory system
21 (25.0)
85 (16.6)
0.046
Central nervous system
27 (32.1)
134 (26.2)
0.157
Renal
50 (59.5)
218 (42.6)
<0.001
Liver
17 (20.2)
90 (17.6)
0.543
Coagulopathy
27 (32.1)
5 (1.0)
<0.001
Diabetes mellitus
24 (28.6)
148 (28.9)
0.885
Arrhythmia
26 (30.9)
102 (19.9)
0.009
Electrolyte imbalance
66 (78.6)
280 (54.7)
<0.001
Postcardiac arrest
29 (34.5)
21 (4.1)
<0.001
CPR preoperative
24 (28.6)
3 (0.6)
<0.001
CPR intraoperative
31 (36.9)
2 (0.4)
<0.001
Operating room set >2 h
13 (15.5)
141 (27.5)
0.007
Investigation
Hemoglobin (g/dL)
9.4 ± 2.9
9.6 ± 2.5
0.669
Hematocrit (%)
28.1 ± 8.4
29.1 ± 7.2
0.279
White blood count (×103/μL)
16.40 ± 12.26
13.83 ± 10.70
0.074
Platelet count (×103/μL)
158.9 ± 84.1
224.1 ± 127.5
<0.001
Blood urea nitrogen (mg/dL)
30.1 ± 23.7
32.6 ± 27.4
0.451
Creatinine (mg/dL)
2.2 ± 1.8
2.2 ± 2.6
0.713
Blood sugar (mg/dL)
167.5 ± 86.1
166.1 ± 78.5
0.917
Sodium (mEq/L)
138.6 ± 8.9
135.7 ± 5.7
0.005
Potassium (mEq/L)
4.0 ± 0.8
3.8 ± 0.7
0.161
Bicarbonate (mEq/L)
16.8 ± 6.5
21.5 ± 4.5
<0.001
Base excess (mEq/L)
−(12.4 ± 6.9)
−(4.4 ± 8.2)
<.0001
Chloride (mEq/L)
100.9 ± 9.8
99.1 ± 6.3
0.111
Lactate (mmol/L)
8.3 ± 4.9
3.9 ± 3.6
<0.001
Albumin (g/dL)
2.5 ± 0.7
2.9 ± 2.4
0.258
Bilirubin (mg/dL)
5.3 ± 7.2
2.4 ± 3.1
0.103
PT (sec)
17.1 ± 6.3
14.0 ± 4.4
0.001
INR
1.7 ± 0.6
1.3 ± 0.4
<0.001
PTT (sec)
42.6 ± 21.8
36.2 ± 15.8
0.030
ALT (unit/L)
66.6 ± 107.5
78.3 ± 155.2
0.751
AST (unit/L)
92.0 ± 79.7
88.8 ± 188.3
0.943
Alkaline phosphatase (IU/L)
130.2 ± 124.2
201.5 ± 180.4
0.098
CXR with significant finding
6 (7.1)
89 (17.4)
0.007
EKG with significant finding
19 (22.6)
96 (18.8)
0.339
Arterial line
50 (59.5)
180 (35.2)
<0.001
CVP (cmH2O)
9.3 ± 8.2
12.0 ± 6.4
0.018
Drug
Inhalation (n) (desflurane/sevoflurane)
20 (23.8)/64 (76.2)
102 (19.9)/410 (80.1)
0.413
Narcotic (n) (morphine/fentanyl)
1 (1.2)/83 (98.8)
6 (1.2)/506 (98.8)
0.988
Induction (n) (propofol/etomidate)
59 (70.2)/25 (29.8)
385 (75.2)/127 (24.8)
0.334
Midazolam
36 (42.9)
103 (20.1)
<0.001
Nitrous oxide
0
13 (2.5)
0.159
Neostigmine
0
13 (2.5)
0.158
Dopamine or dobutamine
40 (47.6)
58 (11.3)
<0.001
Adrenaline
53 (63.1)
16 (3.1)
<0.001
Noradrenaline
47 (56.0)
113 (22.1)
<0.001
Fluid intake
Crystalloid (mL)
1,048.4 ± 870.1
661.4 ± 710.4
<0.001
Colloid (mL)
583.3 ± 927.9
159.4 ± 327.4
<0.001
PRC (unit)
3.6 ± 6.0
0.6 ± 1.3
<0.001
FFP (unit)
2.5 ± 4.3
0.4 ± 0.9
<0.001
Platelet (unit)
2.6 ± 3.9
0.8 ± 2.2
<0.001
Cryoprecipitate (unit)
0.5 ± 2.0
0.1 ± 1.0
0.033
Urine output (mL)
51.4 ± 117.1
156.7 ± 264.3
<0.001
Blood loss (mL)
1,612.2 ± 3,165.4
261.5 ± 675.3
<0.001
Data are presented as mean ± SD or number (%); ASA: American Society of Anesthesiologists; CPR: cardiopulmonary resuscitation; PT: prothrombin time; INR: international normalized ratio; PTT: partial thromboplastin time; ALT: alanine aminotransferase; AST: aspartate aminotransferase; CXR: chest X-ray; EKG: electrocardiogram; CVP: central venous pressure; PRC: pack red cell; FFP: fresh frozen plasma.
