Emergency Surgery Score (ESS)
Emergency Surgery Score (ESS) — a 0-29 preoperative 30-day mortality predictor for emergency general surgery.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Age > 60
- Yes
- Disseminated cancer
- Yes
- Ventilator dependence within 48h preop
- Yes
- Creatinine > 1.2
- Yes
- Albumin < 3.0
- Yes
- WBC band
- > 25k (+2)
Result: ESS 13 of 29 — high predicted 30-day mortality (~36-50% near mid-range).
The tool opens with these values already filled in. Replace them with your own.
What the result means
- 0-3
- Low predicted 30-day mortality (~0-4% in the derivation cohort).
- 4-10
- Intermediate, rising predicted 30-day mortality.
- 11-16
- High predicted 30-day mortality (~36-50% near mid-range).
- >= 17
- Very high predicted 30-day mortality, approaching 100% at ESS >= 22. A mortality band, not an operative order.
What you enter
- Age > 60 (+2)
- White race (+1, derivation coefficient)
- Transfer source (none / outside ED / acute-care inpatient)
- Ascites (+1)
- BMI < 20 (+1)
- Dyspnea (+1)
- Functional dependence (+1)
- COPD (+1)
The other 14 fields
- Hypertension (+1)
- Steroid use (+1)
- > 10% weight loss in 6 months (+1)
- Disseminated cancer (+3)
- Ventilator dependence within 48h preop (+3)
- Albumin < 3.0 (+1)
- Alkaline phosphatase > 125 (+1)
- BUN > 40 (+1)
- INR > 1.5 (+1)
- Platelets < 150k (+1)
- AST > 40 (+1)
- Sodium > 145 (+1)
- Creatinine > 1.2 (+2)
- WBC band (normal / < 4.5 or 15-25k / > 25k)
How this is calculated
Sangji NF, Bohnen JD, Ramly EP, et al. Derivation and validation of a novel Emergency Surgery Acuity Score (ESAS). J Trauma Acute Care Surg. 2016;81(2):213-220. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.