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Risk stratification has become a key part of the care processes for patients having emergency bowel surgery. This study aimed to determine if operative approach influences risk‐model performance, and risk‐adjusted mortality rates in the United Kingdom.

A prospectively planned analysis was conducted using National Emergency Laparotomy Audit (NELA) data from December 2013 to November 2018. The risk‐models investigated were P‐POSSUM and the NELA Score, with model performance assessed in terms of discrimination and calibration. Risk‐adjusted mortality was assessed using Standardised Mortality Ratios (SMR). Analysis was performed for the total cohort, and cases performed open, laparoscopically and converted to open. Sub‐analysis was performed for cases with ≤ 20% predicted mortality.

Data were available for 116 396 patients with P‐POSSUM predicted …