NELA Risk Score (Emergency Laparotomy)
National Emergency Laparotomy Audit (NELA) risk model predicts 30-day mortality for emergency laparotomy. Mandated for all emergency laparotomies in England and Wales.
Score interpretation
→ Standard emergency care; ward or surgical HDU post-op; consultant surgeon and anaesthetist involvement; antibiotic prophylaxis; VTE prevention
→ HDU/Level 2 care post-op; ICU review; consultant surgeon and anaesthetist mandatory; goal-directed fluid therapy; critical care outreach; family consent with numerical risk
→ ICU admission post-op; senior surgeon + senior anaesthetist; goals of care discussion (patient/family); palliative option if patient declines; formal NELA data submission required; avoid surgical delay >2h if <5% risk difference
Interpretation bands for the NELA Score. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Rivaroxaban (Perioperative VTE Prophylaxis) · Direct Oral Anticoagulant — VTE Prophylaxis Post-Surgery
- Tranexamic Acid (ICU/Trauma/Surgical) · Antifibrinolytic
- Labetalol (IV — Hypertensive Emergency) · Combined Alpha-1 and Beta-Adrenergic Blocker
- Protamine Sulphate (Heparin Reversal) · Heparin Reversal / Cardiac Surgery
- Labetalol (IV — Hypertensive Emergency) · Combined alpha and beta blocker
- Tenecteplase · Cardiovascular Emergency
- Major Trauma — Primary Survey (ATLS) · ATLS 10th Edition; JRCALC; NICE NG39
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Burns — TBSA Estimation & Fluid Resuscitation · British Burn Association; EMSB; RCEM 2024
- Lower Gastrointestinal Bleed · NICE; BSG; ACPGBI — Commissioning Guide
- Acute Pancreatitis · NICE; IAP/APA; ACPGBI — CG104
- Hypertrophic Pyloric Stenosis · BAPS / RCPCH
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.