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Modern Predictors of Mortality in Patients Undergoing Emergency Laparotomy / SHAHAB HAJIBANDEH

Swansea University Author: SHAHAB HAJIBANDEH

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DOI (Published version): 10.23889/SUThesis.72057

Abstract

This thesis investigates the modern predictors of 30-day mortality in patients with non-traumatic acute abdominal pathology undergoing emergency laparotomy through 12 studies (six cohort studies and six meta-analyses) published in peer-reviewed medical journals.The design and reporting of the cohort...

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Published: Swansea 2026
Institution: Swansea University
Degree name: Ph.D
Supervisor: Kanamarlapudi, V.
URI: https://cronfa.swan.ac.uk/Record/cronfa72057
first_indexed 2026-06-11T10:18:58Z
last_indexed 2026-06-12T13:21:36Z
id cronfa72057
recordtype RisThesis
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spelling 2026-06-11T11:28:25.1831026 v2 72057 2026-06-11 Modern Predictors of Mortality in Patients Undergoing Emergency Laparotomy b95fa4fe8ce5515ba689c728410200bd SHAHAB HAJIBANDEH SHAHAB HAJIBANDEH true false 2026-06-11 This thesis investigates the modern predictors of 30-day mortality in patients with non-traumatic acute abdominal pathology undergoing emergency laparotomy through 12 studies (six cohort studies and six meta-analyses) published in peer-reviewed medical journals.The design and reporting of the cohort studies followed either the Strengthening the Reporting of Cohort Studies in Surgery (STROCSS) or the Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD).The design and reporting of the meta-analyses followed the Cochrane Handbook for Systematic Reviews and the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement standards.The potential predictors of mortality related to the physical status of the patients, severity of the underlying abdominal pathology, healthcare setting, and socioeconomic status of the patients were evaluated. The variables related to physical status of the patients included age 80 or over (≥ 80), the American Society of Anaesthesiologists (ASA) status, sarcopenia, and clinical frailty scale (CFS). The variables related to the severity of the underlying abdominal pathology included the intraperitoneal contamination index (Hajibandeh Index), the presence of intraperitoneal contamination, and the need for bowel resection. The variables related to healthcare setting included the surgeon's seniority, the surgeon's subspeciality of interest, the weekend effect (operation during weekend), the application of enhanced recovery after surgery (ERAS) protocols in emergency surgery.The aforementioned potential predictors were evaluated in individual studies and then, based on the knowledge obtained regarding the predictive significance of each potential predictor, a predictive model was developed and validated taking into account all important potential predictors. After a very strict multivariable analysis, Hajibandeh Index, ASA status and sarcopenia remained as final independent predictors of mortality after emergency laparotomy. The final model was called HAS which demonstrated excellent discrimination, calibration, and classification. E-Thesis Swansea emergency laparotomy, mortality, Hajibandeh index, sarcopenia 2 6 2026 2026-06-02 10.23889/SUThesis.72057 COLLEGE NANME COLLEGE CODE Swansea University Kanamarlapudi, V. Ph.D 2026-06-11T11:28:25.1831026 2026-06-11T11:10:33.0258469 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Biomedical Science SHAHAB HAJIBANDEH 1 72057__36925__867ba8be6e534857b0f5cd683ae44add.pdf 2026_Hajibandeh_S.final.72057.pdf 2026-06-11T11:17:13.5363514 Output 19486118 application/pdf E-Thesis – open access true Copyright: the author, Shahab Hajibandeh, 2026. Distributed under the terms of a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0). true eng https://creativecommons.org/licenses/by-nc-nd/4.0/
title Modern Predictors of Mortality in Patients Undergoing Emergency Laparotomy
spellingShingle Modern Predictors of Mortality in Patients Undergoing Emergency Laparotomy
SHAHAB HAJIBANDEH
title_short Modern Predictors of Mortality in Patients Undergoing Emergency Laparotomy
title_full Modern Predictors of Mortality in Patients Undergoing Emergency Laparotomy
title_fullStr Modern Predictors of Mortality in Patients Undergoing Emergency Laparotomy
title_full_unstemmed Modern Predictors of Mortality in Patients Undergoing Emergency Laparotomy
title_sort Modern Predictors of Mortality in Patients Undergoing Emergency Laparotomy
author_id_str_mv b95fa4fe8ce5515ba689c728410200bd
author_id_fullname_str_mv b95fa4fe8ce5515ba689c728410200bd_***_SHAHAB HAJIBANDEH
author SHAHAB HAJIBANDEH
author2 SHAHAB HAJIBANDEH
format E-Thesis
publishDate 2026
institution Swansea University
doi_str_mv 10.23889/SUThesis.72057
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Biomedical Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Biomedical Science
document_store_str 1
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description This thesis investigates the modern predictors of 30-day mortality in patients with non-traumatic acute abdominal pathology undergoing emergency laparotomy through 12 studies (six cohort studies and six meta-analyses) published in peer-reviewed medical journals.The design and reporting of the cohort studies followed either the Strengthening the Reporting of Cohort Studies in Surgery (STROCSS) or the Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD).The design and reporting of the meta-analyses followed the Cochrane Handbook for Systematic Reviews and the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement standards.The potential predictors of mortality related to the physical status of the patients, severity of the underlying abdominal pathology, healthcare setting, and socioeconomic status of the patients were evaluated. The variables related to physical status of the patients included age 80 or over (≥ 80), the American Society of Anaesthesiologists (ASA) status, sarcopenia, and clinical frailty scale (CFS). The variables related to the severity of the underlying abdominal pathology included the intraperitoneal contamination index (Hajibandeh Index), the presence of intraperitoneal contamination, and the need for bowel resection. The variables related to healthcare setting included the surgeon's seniority, the surgeon's subspeciality of interest, the weekend effect (operation during weekend), the application of enhanced recovery after surgery (ERAS) protocols in emergency surgery.The aforementioned potential predictors were evaluated in individual studies and then, based on the knowledge obtained regarding the predictive significance of each potential predictor, a predictive model was developed and validated taking into account all important potential predictors. After a very strict multivariable analysis, Hajibandeh Index, ASA status and sarcopenia remained as final independent predictors of mortality after emergency laparotomy. The final model was called HAS which demonstrated excellent discrimination, calibration, and classification.
published_date 2026-06-02T14:21:36Z
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score 11.10865

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