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 emerge ncy laparotomy. Aspects of preoperative assessment, perioperative mana gement and postoperative care were analysed by multiple logistic regre ssion to determine the factors that predicted hospital survival. We de termined which factors influenced anaesthetists' prediction that patie nts would survive. These predictions were made both before and immedia tely 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. Ag e and ASA status were significant predictors of survival (P < 0.05), a nd of anaesthetists' prediction of mortality both before and after ope ration. Several other factors were significant determinants of surviva l but were not determinants of the anaesthetist's opinion regarding su rvival.