Development and Validation of Hajibandeh Emergency Laparotomy Model
Research type
Research Study
Full title
Development and Validation of Hajibandeh Emergency Laparotomy Model: A Retrospective Cohort Study
IRAS ID
320962
Contact name
Nagappan Kumar
Contact email
Sponsor organisation
University Hospital of Wales
Duration of Study in the UK
0 years, 2 months, 0 days
Research summary
Emergency laparotomy carries a high risk of morbidity and mortality. In order to identify patients at high risk of morbidity and mortality following emergency laparotomy, there has been increasing effort to develop and validate accurate risk-prediction models over recent years. Commonly used risk-prediction models for predicting mortality following emergency laparotomy include the Portsmouth-physiological and operative severity score for the enumeration of mortality and morbidity (P-POSSUM) and the National Emergency Laparotomy Audit (NELA) score. Although P-POSSUM was initially the most commonly used model for predicting mortality following emergency laparotomy, it lost its popularity due to concerns about inaccuracy in some subgroups of patients and potential overestimation of mortality.
The Hajibandeh Index (HI), which is derived from combined levels of C-reactive protein (CRP), lactate, neutrophils, lymphocytes and albumin, was developed and validated in our previous studies. It was shown that HI predicts the presence of intraperitoneal contamination in patients with acute abdominal pathology and postoperative mortality in patients undergoing emergency laparotomy. Our recent study showed that HI was better than the NELA score in predicting postoperative mortality in patients aged over 80 undergoing emergency laparotomies; its performance was comparable with NELA score in other subgroups.
We learned from our previous studies that the modern predictors of mortality in patients undergoing emergency laparotomy include HI, age over 80, sarcopenia, American Society of Anesthesiologists (ASA) status above 3, need for bowel resection, and presence of intraperitoneal contamination. We believe that a risk prediction model comprising all of the above may potentially be the best tool for predicting the risk of postoperative mortality in patients undergoing emergency laparotomy. Therefore, we aim to perform a retrospective cohort study to develop and validate the Hajibandeh Emergency Laparotomy Model comprising modern predictors of postoperative mortality in patients undergoing emergency laparotomy.REC name
London - Harrow Research Ethics Committee
REC reference
22/PR/1428
Date of REC Opinion
6 Dec 2022
REC opinion
Further Information Favourable Opinion