SHARP risk score: a predictor of poor outcomes in adults admitted for emergency general surgery: a prospective cohort study

Tanos, Panayiotis, Ablett, Andrew D., Carter, Ben, Ceelen, Wim, Pearce, Lyndsay, Stechman, Michael, McCarthy, Kathryn, Hewitt, Jonathan ORCID: https://orcid.org/0000-0002-7924-1792 and Myint, Phyo Kyaw 2023. SHARP risk score: a predictor of poor outcomes in adults admitted for emergency general surgery: a prospective cohort study. Asian Journal of Surgery 46 (7) , pp. 2668-2674. 10.1016/j.asjsur.2022.10.049

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Abstract

Purpose Post-operative complications following emergency abdominal surgery are associated with significant morbidity and mortality. Despite the knowledge of prognostic factors associated with poor surgical outcomes; few have described risks of poor outcomes based on admission information in acute surgical setting. We aimed to derive a simple, point-of-care risk scale that predicts adults with increased risk of poor outcomes. Methods We used data from an international multi-centre prospective cohort study. The effect of characteristics; age, hypoalbuminaemia, anaemia, renal insufficiency and polypharmacy on 90-day mortality was examined using fully adjusted multivariable models. For our secondary outcome we aimed to test whether these characteristics could be combined to predict poor outcomes in adults undergoing emergency general surgery. Subsequently, the impact of incremental increase in derived SHARP score on outcomes was assessed. Results The cohort consisted of 419 adult patients between the ages of 16–94 years (median 52; IQR(39) consecutively admitted to five emergency general surgical units across the United Kingdom and one in Ghent, Belgium. In fully adjusted models the aforementioned characteristics; were associated with 90-day mortality. SHARP score was associated with higher odds of mortality in adults who underwent emergency general surgery, with a SHARP score of five also being associated with an increased length of hospital stay. Conclusions SHARP risk score is a simple prognostic tool, using point-of-care information to predict poor outcomes in patients undergoing emergency general surgery. This information may be used to improve management plans and aid clinicians in delivering more person-centred care. Further validation studies are required to prove its utility.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Additional Information:	License information from Publisher: LICENSE 1: URL: http://creativecommons.org/licenses/by-nc-nd/4.0/, Start Date: 2022-10-22
Publisher:	Elsevier
ISSN:	1015-9584
Date of First Compliant Deposit:	8 November 2022
Date of Acceptance:	20 October 2022
Last Modified:	03 Aug 2023 16:28
URI:	https://orca.cardiff.ac.uk/id/eprint/154047

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