World Journal of Surgery

, Volume 33, Issue 6, pp 1259–1265 | Cite as

Validation of the Estimation of Physiologic Ability and Surgical Stress (E-PASS) Score in Liver Surgery

  • Vanessa M. Banz
  • Peter Studer
  • Daniel Inderbitzin
  • Daniel CandinasEmail author



The estimation of physiologic ability and surgical stress (E-PASS) has been used to produce a numerical estimate of expected mortality and morbidity after elective gastrointestinal surgery. The aim of this study was to validate E-PASS in a selected cohort of patients requiring liver resections (LR).


In this retrospective study, E-PASS predictor equations for morbidity and mortality were applied to the prospective data from 243 patients requiring LR. The observed rates were compared with predicted rates using Fisher’s exact test. The discriminative capability of E-PASS was evaluated using receiver-operating characteristic (ROC) curve analysis.


The observed and predicted overall mortality rates were both 3.3% and the morbidity rates were 31.3 and 26.9%, respectively. There was a significant difference in the comprehensive risk scores for deceased and surviving patients (p = 0.043). However, the scores for patients with or without complications were not significantly different (p = 0.120). Subsequent ROC curve analysis revealed a poor predictive accuracy for morbidity.


The E-PASS score seems to effectively predict mortality in this specific group of patients but is a poor predictor of complications. A new modified logistic regression might be required for LR in order to better predict the postoperative outcome.


Liver Resection Hepatic Resection Postoperative Liver Failure Systemic Inflammatory Response Syndrome Criterion Comprehensive Risk Score 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Société Internationale de Chirurgie 2009

Authors and Affiliations

  • Vanessa M. Banz
    • 1
  • Peter Studer
    • 1
  • Daniel Inderbitzin
    • 1
  • Daniel Candinas
    • 1
    Email author
  1. 1.Department of Visceral Surgery and MedicineInselspital, Bern University Hospital and University of BernBernSwitzerland

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