New research identifies the best scoring system to predict outcomes in emergency laparotomy patients.

• The NELA score shows the highest accuracy for 30-day mortality with a c-statistic of 0.979.
• The Hajibandeh index excels in sensing surgical site infections (0.760) and anastomotic leaks (0.741).
• The P-POSSUM score is most specific for predicting re-exploration, aiding in surgical planning.

Integrating these risk assessment tools can enhance patient selection and improve surgical outcomes.