Suscribirse

The utility of predictive scores for intraoperative or postoperative morbi-mortality in visceral surgery - 10/12/25

Doi : 10.1016/j.jviscsurg.2025.11.009 
Karem Slim a, , Julie Veziant b, c, Afak Nsiri d, e, Arnaud Alves f
a Pôle Santé République, ELSAN Group, 99, avenue de la République, 63000 Clermont-Ferrand, France 
b Digestive and Oncological Surgery Department, Claude-Huriez Hospital, Lille University Hospital, 59000 Lille, France 
c Inserm, CNRS, UMR9020-U1277-CANTHER-Cancer, 59000 Lille, France 
d Ibn Rochd University Hospital, rue des Hôpitaux, Casablanca, Morocco 
e Hassan II University, rue Tarik Ibnou Ziad, Casablanca, Morocco 
f Inserm Unit UMR 1086 Anticipe, Calvados Digestive Tumour Registry, University of Caen-Normandy, Caen, France 

Corresponding author.
En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Wednesday 10 December 2025

Highlights

Validation of a predictive score for morbi-mortality is carried out in accordance with a well-defined process: internal validation, external validation, calculation of discriminant and calibration capacity, and analysis of its clinical impact.
Few of the predictive scores put forward in the literature have been subjected to the full validation process with regard to scheduled visceral surgery.
In spite of its insufficiently discriminative performances, the ASA-PS score is the most widely used in current practice.
The SORT score is more effectively predictive than the POSSUM scores.
Up until now, no specific organ-based score had received formal external validation.
The role of artificial intelligence in the form of machine learning, otherwise known as automatic learning, remains to be defined.

El texto completo de este artículo está disponible en PDF.

Summary

The objective of this narrative review of the literature was to discuss the original concept and ongoing validation of predictive scores for intraoperative or postoperative morbi-mortality, and their overall utility in scheduled visceral surgery. The development and validation of a predictive score for morbi-mortality is carried out by means of a well-defined process encompassing internal and external validation according to temporality, geographical location or domain (patient population and/or type of surgery), and the clinical impact of application of the score. Bibliographic analysis has shown that very few existing studies possess the required methodological qualities. Detailed individual analysis of the different scores, not including nutritional scores, showed that the ASA-PS score is easy to use but yields only moderate performance, that the SORT score (six variables) is more powerfully discriminatory than the POSSUM score, that the POSPOM score has not been validated in visceral surgery, that the ACS-NSQIP score cannot be utilized in Europe and, finally, that the Charlson index is not sufficiently discriminatory in the short term. If specific types of surgery are taken into consideration, none of these scores have received formal external validation. In conclusion, the SORT score has been the most validated, and the ASA-PS score is widely used in current practice. The role of artificial intelligence in the form of machine learning remains to be defined.

El texto completo de este artículo está disponible en PDF.

Keywords : Predictive tests, Prediction, Morbidity, Mortality, Visceral surgery


Esquema

Validation [, , , , , , , , , ]

© 2025  Elsevier Masson SAS. Reservados todos los derechos.
Añadir a mi biblioteca Eliminar de mi biblioteca Imprimir
Exportación

    Exportación citas

  • Fichero

  • Contenido

Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
El acceso al texto completo de este artículo requiere una suscripción.

¿Ya suscrito a @@106933@@ revista ?

Mi cuenta


Declaración CNIL

EM-CONSULTE.COM se declara a la CNIL, la declaración N º 1286925.

En virtud de la Ley N º 78-17 del 6 de enero de 1978, relativa a las computadoras, archivos y libertades, usted tiene el derecho de oposición (art.26 de la ley), el acceso (art.34 a 38 Ley), y correcta (artículo 36 de la ley) los datos que le conciernen. Por lo tanto, usted puede pedir que se corrija, complementado, clarificado, actualizado o suprimido información sobre usted que son inexactos, incompletos, engañosos, obsoletos o cuya recogida o de conservación o uso está prohibido.
La información personal sobre los visitantes de nuestro sitio, incluyendo su identidad, son confidenciales.
El jefe del sitio en el honor se compromete a respetar la confidencialidad de los requisitos legales aplicables en Francia y no de revelar dicha información a terceros.


Todo el contenido en este sitio: Copyright © 2025 Elsevier, sus licenciantes y colaboradores. Se reservan todos los derechos, incluidos los de minería de texto y datos, entrenamiento de IA y tecnologías similares. Para todo el contenido de acceso abierto, se aplican los términos de licencia de Creative Commons.