Table 4.
Multivariate logistic regression model of the significant factors associated with 30-day mortality in emergency general surgical admissions.
| Unadjusted |
Adjusted |
|||
|---|---|---|---|---|
| OR (95% CI) | p-value | OR (95% CI) | p-value | |
| Patient Characteristics | ||||
| Admission Period | ||||
| Pre-Lockdown | 1.00 | |||
| Post-Lockdown | 3.11 (1.08,9.00) | 0.036 | 1.20 (0.22,6.56) | 0.830 |
| Age | 1.07 (1.03,1.11) | 0.001 | 1.05 (0.98,1.12) | 0.206 |
| Gender | ||||
| Male | 1.00 | |||
| Female | 1.75 (0.55,5.64) | 0.346 | ||
| Ethnicity | ||||
| White | 1.00 | |||
| BAME | 0.00 (0.00,0.00) | 0.999 | ||
| Deprivation Quintile | ||||
| 1 (Most) | 1.00 | |||
| 2 | 0.23 (0.03,1.80) | 0.160 | ||
| 3 | 0.44 (0.06,3.60) | 0.446 | ||
| 4 | 0.39 (0.05,3.16) | 0.379 | ||
| 5 (Least) | 0.63 (0.13,3.01) | 0.565 | ||
| Charlson Comorbidity Score | 1.14 (1.07,1.21) | <0.001 | 1.19 (1.07,1.32) | 0.001 |
| Hypertensive | 2.76 (0.94,8.06) | 0.064 | 0.77 (0.11,5.24) | 0.786 |
| Pre-existing Respiratory Disease | 0.76 (0.17,3.49) | 0.727 | ||
| Diabetes Mellitus | 2.49 (0.75,8.21) | 0.135 | 1.73 (0.27,10.9) | 0.562 |
| Heart Failure | 4.41 (1.13,17.2) | 0.033 | 1.57 (0.15,16.2) | 0.707 |
| Obesity (BMI >30) | 0.36 (0.08,1.63) | 0.186 | ||
| Chronic Kidney Disease | 4.41 (1.13,17.2) | 0.033 | 0.24 (0.02,3.05) | 0.269 |
| ASA Classification | ||||
| 1 | 1.00 | |||
| 2 | 2.07 (0.37,11.6) | 0.408 | ||
| 3 | 13.8 (3.41,56.1) | <0.001 | 1.84 (0.09,37.5) | 0.693 |
| 4 | 16.6 (2.53,108) | 0.003 | 1.79 (0.43,2.48) | 0.464 |
| COVID-19 Diagnosis | 0.00 (0.00,0.00) | 0.999 | ||
| Clinical Condition | ||||
| NEWS Score (Admission) | 1.64 (1.32,2.05) | <0.001 | 1.80 (1.25,2.58) | 0.001 |
| White Cell Count (Admission) | 1.17 (1.08,1.28) | <0.001 | 0.99 (0.88,1.12) | 0.888 |
| C-Reactive Protein (Admission) | 1.01 (1.00,1.01) | <0.001 | 1.00 (1.00,1.01) | 0.171 |
| Acute Kidney Injury (Admission) | 9.99 (3.34,29.9) | <0.001 | 5.75 (1.25,26.44) | 0.025 |
| Lactate (Admission) | 1.85 (1.42,2.43) | <0.001 | 1.49 (1.07,2.08) | 0.017 |
| Acidosis (Admission) | 17.7 (4.36,71.8) | <0.001 | 1.77 (0.16,19.9) | 0.643 |
| NELA Score | 1.04 (1.00,1.09) | 0.067 | 1.03 (1.00,1.05) | 0.042 |
| Clinical Diagnosis | ||||
| Appendicitis | 0.00 (0.00,0.00) | 0.996 | ||
| Biliary Pathology | 0.73 (0.16,3.32) | 0.682 | ||
| Diverticular Disease | 1.70 (0.21,14.0) | 0.621 | ||
| Gastrointestinal Bleeding | 0.00 (0.00,0.00) | 0.999 | ||
| Gastrointestinal Cancer | 8.67 (2.41,31.2) | 0.001 | 7.04 (0.54,91.5) | 0.136 |
| Gastrointestinal Perforation | 21.6 (6.90,67.4) | <0.001 | 13.8 (2.75,69.7) | 0.001 |
| Hernia | 0.00 (0.00,0.00) | 0.997 | ||
| Inflammatory Bowel Disease/Colitis | 0.00 (0.00,0.00) | 0.998 | ||
| Obstruction | 0.66 (0.08,5.22) | 0.696 | ||
| Ischaemic Bowel | 12.2 (2.71,54.6) | 0.001 | 13.8 (1.27,150) | 0.031 |
| Non-Specific Abdominal Pain | 0.00 (0.00,0.00) | 0.998 | ||
| Non-Surgical Diagnosis | 1.68 (0.36,7.87) | 0.510 | ||
| Other Relevant Surgical Pathology | 0.00 (0.00,0.00) | 0.998 | ||
| Pancreatitis | 0.82 (0.10,6.47) | 0.847 | ||
| Peptic Ulcer Disease | 1.05 (0.13,8.41) | 0.964 | ||
| Superficial Infection/Abscess | 0.00 (0.00,0.00) | 0.997 | ||
| Trauma | 0.00 (0.00,0.00) | 0.997 | ||
| Patient Management | ||||
| Imaging | 0.00 (0.00,0.00) | 0.997 | ||
| Endoscopic Intervention | 1.70 (0.21,14.0) | 0.621 | ||
| Radiological Intervention | 2.97 (0.34,25.8) | 0.324 | ||
| Operative Intervention | 0.73 (0.23,2.35) | 0.599 | ||
| Operative Severity | ||||
| Minor | 1.00 | |||
| Moderate | 0.00 (0.00,0.00) | 0.997 | ||
| Major/Complex Major | 1.95 (0.520,7.36) | 0.321 | ||
| Operative Approach | ||||
| Laparoscopic | 1.00 | |||
| Open | 2.00 (0.53,7.51) | 0.304 | ||
OR = Odds ratio. 95% CI = 95% Confidence Interval. BAME, Black Asian and Minority Ethnic; BMI, Body Mass Index; ASA, American Society of Anesthesiologists; NEWS, National Early Warning Score; NELA, National Emergency Laparotomy Audit.