Abstract
Purpose
The Estimation of Physiologic Ability and Surgical Stress (E-PASS) scoring system, which quantifies a patient’s reserve and surgical stress, is used to predict morbidity and mortality in patients before elective gastrointestinal surgery. We conducted this study to clarify whether the E-PASS scoring system is useful for assessing the risks of emergency abdominal surgery.
Methods
The subjects of this retrospective study were 51 patients who underwent emergency gastrointestinal surgery at a public general hospital. The main outcomes were the E-PASS scores and the postoperative course, defined by mortality and morbidity.
Results
Postoperative complications developed in 15 of the 51 patients (29.4%). The E-PASS score was significantly higher in the patients with postoperative complications than in those without (0.61 ± 0.31 vs 0.20 ± 0.35, respectively; n = 36). The morbidity rates were significantly lower in the patients with a value less than 0.5 than in those with a value more than 0.5 (17.1% and 56.3%, respectively; P < 0.01). There were 7 operative deaths among the 16 patients with a high score, versus none among the 9 patients with a low score (P < 0.01). Three patients underwent laparoscopic-assisted bowel resection with a good postoperative course, with scores of less than 0.5.
Conclusions
The E-PASS scoring system is useful for surgical decision making and evaluating whether patients will tolerate emergency gastrointestinal surgery. Minimally invasive therapy would assist in lowering the risk of complications.
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This paper was presented at the 62nd Annual Meeting of the Japanese Society of Gastroenterological Surgery in Tokyo, Japan, on July 19, 2007.
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Koushi, K., Korenaga, D., Kawanaka, H. et al. Using the E-PASS scoring system to estimate the risk of emergency abdominal surgery in patients with acute gastrointestinal disease. Surg Today 41, 1481–1485 (2011). https://doi.org/10.1007/s00595-010-4538-z
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DOI: https://doi.org/10.1007/s00595-010-4538-z