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European Journal of Trauma and Emergency Surgery

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01-10-2021 | Acetabular Fracture | Original Article

The use of the E-PASS scoring system in determining complication development in patients with isolated acetabular fractures

Authors: Paul Gilbert Fairhurst, Dionysios Tsinas, Carlos Correa Shokiche, Marius Johann Baptist Keel, Klaus Arno Siebenrock, Johannes Dominik Bastian

Published in: European Journal of Trauma and Emergency Surgery | Issue 5/2021

Abstract

Background

The decision to treat acetabular fractures is occasionally deferred or foregone in patients perceived to be unfit for surgery. The previously validated estimation of physiologic ability and surgical stress (E-PASS) score has been shown to predict outcome in a variety of fractures, and consists of a preoperative risk score (PRS), a surgical stress score (SSS), and a comprehensive risk score (CRS).

Purpose

To correlate E-PASS and its components with postoperative complication to quantify risk for individual surgical and patient factors in acetabular fracture management.

Methods

A retrospective review of patient records was performed for all patients with acetabular fractures surgically treated between January 2013 and June 2018 in a level 1 Trauma Centre. Patients with multiple injuries and/or malignancies were excluded. E-PASS scores were determined with standard demographic data and subscores were correlated with complication development.

Results

Of the included 106 patients (mean age 61 years, range 17–93), complications were reported in 37 (34.9%) patients and 3 (2.8%) died. Hospital postoperative morbidity and mortality rates increased significantly with the PRS and CRS. The SSS did not correlate significantly with frequency of complications. Age was found to be the only significant independent risk factor (p value = 0.031, OR = 1.03 per year of age).

Conclusion

Latent patient factors have a clear influence on adverse outcomes in contrast to controllable factors such as surgical stress indicating an important role for perioperative care in reducing postoperative complications. Integrated orthogeriatric care with assessment of comorbidities, prevention or early recognition, and treatment of perioperative complications is essential.

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Title: The use of the E-PASS scoring system in determining complication development in patients with isolated acetabular fractures
Authors: Paul Gilbert Fairhurst
Dionysios Tsinas
Carlos Correa Shokiche
Marius Johann Baptist Keel
Klaus Arno Siebenrock
Johannes Dominik Bastian
Publication date: 01-10-2021
Publisher: Springer Berlin Heidelberg
Keyword: Acetabular Fracture
Published in: European Journal of Trauma and Emergency Surgery / Issue 5/2021
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-020-01395-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The use of the E-PASS scoring system in determining complication development in patients with isolated acetabular fractures

Abstract

Background

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Purpose

Methods

Results

Conclusion

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