Parsimonious NELA RISK calculator disclaimer

• The NELA risk calculation tool provides an estimate of the risk of death within 30 days of emergency abdominal surgery. It has been developed using the data gathered from patients entered into the National Emergency Laparotomy Audit between December 2016 and November 2019. The model is an estimate taking into account the risks of the procedure and information about the patients. Not every factor which may affect outcome is included and so there may be other patient, surgical and process factors which will influence the risk of death.
• The NELA risk prediction tool has been shown to be more accurate than the P-POSSUM calculator for patients undergoing emergency laparotomy in the UK but will be reviewed at regular intervals for accuracy against contemporary patient populations.
• The NELA risk tool should not be used in isolation but as part of the overall clinical decision making process to aid multidisciplinary discussion and discussions with the patient and their family.
• NELA is not responsible for decisions made by health care professionals and patients which are made based on the estimations provided by NELA or liable for any outcomes of these patients.
• Technical documentation on the development of the NELA parsimonious risk score can be found here: Risk Coefficients

I confirm that I have read the disclaimer above

Patient name

Hospital Number

Age on arrival?

Hospital / Ward

Consultant

What was the ASA score?

1: No systemic disease
2: Mild systemic disease
3: Severe systemic disease, not life-threatening
4: Severe, life-threatening
5: Moribund patient

Albumin (g/L)

Pulse rate (bpm)

Systolic blood pressure (mmhg)

Serum urea concentration (mmol/l)

Serum white cell count (x10^9 / l)

Glasgow coma scale

What severity of malignancy is anticipated to be present?

None
Primary only
Nodal metastases
Distant metastases

Select an option that best describes this patient's respiratory history and chest xray appearance?

No dyspnoea
Dyspnoea on exertion or CXR: mild COPD
Dyspnoea limiting exertion to <1 flight or CXR moderate COPD
Dyspnoea at rest/rate >30 at rest or CXR: fibrosis or consolidation

Please select the urgency of surgical intervention

3. Expedited (>18 hours)
2B. Urgent (6-18 hours)
2A. Urgent (2-6 hours)
1.Immediate (<2 hours)

Please select a value that best describes the likely degree of peritoneal soiling

None
Serous fluid
Localised pus
Free bowel content, pus or blood

Indications for surgery

Bleeding
Haemorrhage
Other
Abdominal wound dehiscence
Abdominal compartment syndrome
Planned relook
Other
Obstruction
Tender Small bowel obstruction
Non-Tender Small bowel obstruction
Tender Large bowel obstruction
Non-Tender Large bowel obstruction
Gastric outlet obstruction
Incarcerated/strangulated hernia
Hiatus Hernia/para-oesophageal hernia
Volvulus
Internal hernia
Obstructing incisional hernia
Intussusception
Pseudo-obstruction
Foreign body
Sepsis
Phlegmon
Pneumoperitoneum
Sepsis
Iatrogenic injury
Anastomotic leak
Peritonitis
GI Perforation
Abdominal abscess
Intestinal fistula
Ischaemia
Necrosis
Ischaemia/infarction
Colitis
Acidosis

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Estimated mortality using NELA risk adjustment model: