Hospital mortality after urgent and emergency laparotomy in patients aged 65 yr and over. Risk and prediction of risk using multiple logistic regression analysis.
We studied 107 patients aged over 65 years undergoing urgent or emergency laparotomy. Aspects of preoperative assessment, perioperative management and postoperative care were analysed by multiple logistic regression to determine the factors that predicted hospital survival. We determined which factors influenced anaesthetists' prediction that patients would survive. These predictions were made both before and immediately after operation. The factors associated with the use of invasive cardiovascular monitoring were also studied. We obtained a model that accounted for 93% of the variability in the likelihood of survival. Age and ASA status were significant predictors of survival (P < 0.05), and of anaesthetists' prediction of mortality both before and after operation. Several other factors were significant determinants of survival but were not determinants of the anaesthetist's opinion regarding survival.
Royal United Hospital, Bath.
T M
TM
Cook
C J
CJ
Day
D000368:Aged; D000369:Aged, 80 and over; D004630:Emergencies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007813:Laparotomy / Q000401:mortality*; D008297:Male; D008962:Models, Theoretical; D010865:Pilot Projects; D011446:Prospective Studies; D012372:ROC Curve; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors