Surgery Today

, Volume 31, Issue 7, pp 569–574

Evaluation of an Estimation of Physiologic Ability and Surgical Stress (E-PASS) Scoring System to Predict Postoperative Risk: A Multicenter Prospective Study

  • Yoshio Haga
  • Satoshi Ikei
  • Yasuo Wada
  • Hitoshi Takeuchi
  • Hirofumi Sameshima
  • Osamu Kimura
  • Takumi Furuya
Original Articles

DOI: 10.1007/s005950170088

Cite this article as:
Haga, Y., Ikei, S., Wada, Y. et al. Surg Today (2001) 31: 569. doi:10.1007/s005950170088

Abstract

We previously reported generating a scoring system termed E-PASS that predicted postsurgical risk. This study was undertaken to evaluate the usefulness of this system. A consecutive series of 902 patients who underwent elective gastrointestinal operations in six national hospitals in Japan were prospectively assessed for a comprehensive risk score (CRS) of the E-PASS, which was compared with their postoperative course. The postoperative morbidity rates linearly increased as the CRS increased. The postoperative mortality rate was only 0.13%, when the CRS was below 0.5; however, it increased to 9.7% when the CRS ranged from 0.5 to <1.0, and to 26.9% when the CRS was ≥1.0. The CRS correlated significantly with the severity of postoperative complications (rs = 0.527, P < 0.0001) and the costs of hospital stay (rs = 0.810, P < 0.0001). When the CRS-adjusted mortality rate at the CRS of ≥0.5 was compared among the hospitals, it was related to the hospital volume of operations, being 44.2% at the volume of <100 cases per year, 20.6% at the range of 100–199 cases, and 8.6% at the volume of ≥200 cases. These results suggest that E-PASS may be useful for predicting postsurgical risk, estimating medical expense, and comparing surgical quality.

Key words Postoperative morbidity Postoperative mortality Surgical audit Medical expense 

Copyright information

© Springer-Verlag 2001

Authors and Affiliations

  • Yoshio Haga
    • 1
  • Satoshi Ikei
    • 1
  • Yasuo Wada
    • 2
  • Hitoshi Takeuchi
    • 3
  • Hirofumi Sameshima
    • 4
  • Osamu Kimura
    • 5
  • Takumi Furuya
    • 6
  1. 1.Department of Surgery, Kumamoto National Hospital, 1-5 Ninomaru, Kumamoto 860-0008, JapanJP
  2. 2.Department of Surgery, Himeji National Hospital, 68 Hon-machi, Himeji 670-8520, JapanJP
  3. 3.Department of Surgery, Iwakuni National Hospital, 2-5-1 Kuroiso, Iwakuni 740-8510, JapanJP
  4. 4.Department of Surgery, Miyakonojo National Hospital, 5033-1 Iwayoshi-cho, Miyakonojo 885-0014, JapanJP
  5. 5.Department of Surgery, Yonago National Hospital, 1293-1 Kuzumo, Yonago 683-7111, JapanJP
  6. 6.Department of Surgery, Yamaguchi National Hospital, 7-3 Kogushi, Toyoura-cho, Toyoura-gun, Yamaguchi 759-6302, JapanJP

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