The Emergency surgery score (ESS) accurately predicts outcomes of emergency surgical admissions at a Saudi academic health center.

Abstract Background The emergency surgery score (ESS) has emerged as a tool to predict outcomes in emergency surgery (EGS) patients. Our study examines the ability of ESS to predict outcomes in EGS admissions. Methods All EGS admissions to King Saud University Medical City (KSUMC) from January 2017 to October 2019 were included. ESS was calculated for each patient. Correlations between ESS and 30-day mortality and complications were evaluated. Results 1607 patients were included. 30-day mortality rate was 2.2% while complication rate was 18.7%. Mortality increased as ESS increased, from 0.3% for ESS≤2, to 30.1% for ESS >10, with a c-statistic of 0.88. Complication rates were 2.2%, 40%, and 100% at ESS of 0, 6, and 15, respectively, with a c-statistic of 0.82. Conclusions ESS accurately predicted outcomes at our tertiary center. ESS could be useful in identifying high risk EGS admissions and in benchmarking quality of care across Saudi institutions.