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International Journal of Colorectal Disease

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01-02-2016 | Original Article

E-PASS score as a useful predictor of postoperative complications and mortality after colorectal surgery in elderly patients

Authors: Tetsuro Tominaga, Hiroaki Takeshita, Katsunori Takagi, Masaki Kunizaki, Kazuo To, Takafumi Abo, Shigekazu Hidaka, Atsushi Nanashima, Takeshi Nagayasu, Terumitsu Sawai

Published in: International Journal of Colorectal Disease | Issue 2/2016

Abstract

Purpose

The aim of this study was to clarify whether a surgical-specific risk scoring system estimating the physiologic ability and surgical stress (E-PASS) score was useful for prediction of postoperative morbidity and mortality.

Methods

The E-PASS score consists of the preoperative risk score (PRS), surgical stress score (SSS), and the comprehensive risk score (CRS). Conventional scoring systems [colorectal physiologic and operative severity score for the enumeration of mortality (CR-POSSUM) and the prognostic nutritional index (PNI)] were also examined. We retrospectively compared these scores in patients with or without postoperative complications. We assessed the relationship between these scores, clinicopathological features and postoperative mortality.

Results

Postoperative complications developed in 78 patients (33 %). American Society of Anesthesiologists score, performance status, PNI score, PRS, SSS, and CRS were significantly higher in patients with postoperative complications than in those without postoperative complications (p < 0.05). The area under the receiver operating characteristic curve (AUC) was highest for E-PASS [E-PASS (PRS, 0.74; SSS, 0.62; CRS, 0.78), PNI (0.62), CR-POSSUM (PS, 0.57; OSS, 0.52)]. Multivariate logistic analysis identified CRS ≥ 0.2 as a significant determinant of postoperative complications (p < 0.01; hazard ratio, 4.84). Overall survival was significantly better in the CRS < 0.2 group than in the CRS > 0.2 group (p < 0.01).

Conclusions

The E-PASS score system was a useful predictor of postoperative complications and mortality, especially in patients with advanced age.

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Title: E-PASS score as a useful predictor of postoperative complications and mortality after colorectal surgery in elderly patients
Authors: Tetsuro Tominaga
Hiroaki Takeshita
Katsunori Takagi
Masaki Kunizaki
Kazuo To
Takafumi Abo
Shigekazu Hidaka
Atsushi Nanashima
Takeshi Nagayasu
Terumitsu Sawai
Publication date: 01-02-2016
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 2/2016
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-015-2456-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

E-PASS score as a useful predictor of postoperative complications and mortality after colorectal surgery in elderly patients

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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