“Emergency surgery carries higher risk of mortality and morbidity. Appropriate risk assessment, attentive decision-making and carefully selected interventions are the cornerstones of a patient centered management.” (Leiner)

“Frailty, a “syndrome of loss of reserves,” is more than decade old concept. Initially it was used mainly in geriatrics but lately its use has been extended into other specialties including surgery. A meta-analysis demonstrated that frail surgical patients had a higher risk of readmission and increased risk of mortality.” (Leiner)

ACS NSQIP Surgical Risk Calculator

“This study evidenced mortality of 92% in the first 30 post-operative days in a series of patients with a risk defined as extreme (≥ 75%) according to the ACS NSQIP Surgical Risk Calculator who underwent emergency laparotomy during a 4-year period. This analysis also showed that more than half of them died during the first 24 h of the postoperative period and that in only two (2/4) of the surviving patients could there be a benefit resulting from surgery, since in the other two survivors of the series there were no findings that retrospectively justified surgery.” (Ramírez-Giraldo)

Leiner T, Nemeth D,et al Frailty and Emergency Surgery: Results of a Systematic Review and Meta-Analysis. Front Med (Lausanne). 2022 Mar 31;9:811524 Free Full Text

Ramírez-Giraldo C, et al Surgical mortality in patients in extremis: futility in emergency abdominal surgery. BMC Surg. 2023 Jan 27;23(1):21. Free Full Text