Surgical mortality is the most significant measure of outcome in surgical healthcare. The objective was to assess surgical 30 days mortality and improve the identification of predictors for personalized risk stratification of patients undergoing elective and emergency surgery. The study was conducted as a single-center cohort retrospective observational study, based on the analysis of data collected from patients surgically treated from 2002 to 2014 in a multi-disciplinary research and care referral hospital with global case mix of 1.27. The overall in-hospital mortality rate was 1.89% (95% CI 1.82–1.95). In the univariable analysis, numerous predictors were significantly associated with in-hospital death following surgery. In the multivariable model, age, BMI (Body Mass Index), ASA score, department, planned surgical complexity, surgical priority, previous surgeries in the same hospitalization, cardiovascular, pulmonary, hepato-renal comorbidities, drug intolerance, cancer and AIDS were independently associated with mortality after surgery. At logistic regression, the computed SMATT score (graded 0–100), generated on the basis of multivariate analysis, demonstrated a good discrimination (10-fold cross-validated AUC-ROC 0.945, 95%CI 0.941–0.948) and correctly classified 98.5% of those admissions with a probability of death >50%. The novel SMATT score, based on individual preoperative and surgical factors, accurately predicts mortality and provides dynamic information of the risk in redo/reoperative surgery.

手术死亡率是外科医疗保健结果的最重要指标。目的是评估30天手术的死亡率，并改善对择期和急诊手术患者进行个性化风险分层的预测因素。该研究作为一项单中心队列回顾性观察性研究进行，基于对2002年至2014年间在多学科研究和护理转诊医院中接受手术治疗的患者的数据进行的分析，该患者的全球病例数为1.27。总体住院死亡率为1.89％（95％CI为1.82-1.95）。在单变量分析中，许多预测因素与手术后院内死亡显着相关。在多变量模型中，年龄，BMI（身体质量指数），ASA评分，科室，计划的手术复杂性，手术优先级，先前在同一住院中进行的手术，心血管，肺，肝肾合并症，药物耐受不良，癌症和艾滋病与术后死亡率均独立相关。在逻辑回归中，基于多元分析得出的计算出的SMATT评分（0-100分）显示出良好的区分度（10倍交叉验证的AUC-ROC 0.945、95％CI 0.941-0.948）并正确分类为98.5死亡可能性> 50％的入院人数的百分比。基于个体术前和手术因素的新颖SMATT评分可准确预测死亡率，并提供有关重做/再手术风险的动态信息。癌症和艾滋病与术后死亡率独立相关。在逻辑回归中，基于多元分析得出的计算出的SMATT评分（0-100分）显示出良好的区分度（10倍交叉验证的AUC-ROC 0.945、95％CI 0.941-0.948）并正确分类为98.5死亡可能性> 50％的入院人数的百分比。基于个体术前和手术因素的新颖SMATT评分可准确预测死亡率，并提供有关重做/再手术风险的动态信息。癌症和艾滋病与术后死亡率独立相关。在逻辑回归中，基于多元分析得出的计算出的SMATT得分（0-100分）显示出良好的区分度（10倍交叉验证的AUC-ROC 0.945、95％CI 0.941-0.948）并正确分类98.5死亡可能性> 50％的入院人数的百分比。基于个体术前和手术因素的新颖SMATT评分可准确预测死亡率，并提供有关重做/再手术风险的动态信息。50％。基于个体术前和手术因素的新颖SMATT评分可准确预测死亡率，并提供有关重做/再手术风险的动态信息。50％。基于个体术前和手术因素的新颖SMATT评分可准确预测死亡率，并提供有关重做/再手术风险的动态信息。