Risk Assessment in Emergency General Surgery

Patients with emergency general surgery (EGS) diseases display variable severity. The extent of disease can be amplified by comorbidity or dramatic changes in presenting physiology. Estimating the extent of disease severity in order to adequately provide prognosis, determine optimal operative or non-operative management, and plan for potential outcomes is difficult. A variety of risk factors have been studied for specific diseases but these criteria may not be universally applied. This limits the generalizability of prior work. The American Association for the Surgery of Trauma (AAST) created a grading system wherein uniform definitions could be applied to begin to measure disease severity in a granular manner. This review presents some of the initial work focused on the validation and incorporation of the AAST EGS grading system. The authors evaluate several diseases wherein the AAST EGS grade has been applied. Finally the work concludes with a review of several inclusive risk estimation tools. Taken together, the ability to measure disease severity - whether by anatomic changes, physiologic disturbance, or patient comorbidity status - will provide a better method to appraise, research, and improve patient care for several EGS conditions. Corresponding Author: Marie Crandall, MD, MPH, FACS, University of Florida College of Medicine Jacksonville, 655 W. 8th Street, Jacksonville, FL 32209, marie.crandall@jax.ufl.edu The authors have no conflicts of interest, disclosures, or utilized any funding to generate this work. This work was presented at the 76th Annual Meeting of the annual meeting of the AAST during September 13-16, 2017 in Baltimore, Maryland, USA. © 2018 Lippincott Williams & Wilkins, Inc.

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