Evaluation of estimation of physiologic ability and surgical stress (E-PASS) to predict the postoperative risk for hip fracture in elder patients

• Published in: Archives of orthopaedic and trauma surgery 2008-12, Vol.128 (12), p.1447-1452
• Main Authors: Hirose, J., Mizuta, H., Ide, J., Nomura, K.
• Format: Article
• Language: English
• Subjects: Adaptation, Physiological; Adaptation, Psychological; Age Factors; Aged; Aged, 80 and over; Cohort Studies; Female; Fracture Fixation, Intramedullary - methods; Fracture Fixation, Intramedullary - mortality; Fracture Fixation, Intramedullary - psychology; Fracture Healing - physiology; Fractures; Geriatric Assessment; Health risk assessment; Health Status Indicators; Hip Fractures - mortality; Hip Fractures - psychology; Hip Fractures - surgery; Hospital Costs; Humans; Joint surgery; Length of Stay - economics; Male; Medicine; Medicine & Public Health; Orthopaedic Outcome Assessment; Orthopedics; Postoperative Complications - etiology; Postoperative Complications - mortality; Postoperative Complications - psychology; Postoperative period; Predictive Value of Tests; Probability; Prospective Studies; Recovery of Function; Risk Assessment; Statistics, Nonparametric; Stress, Physiological; Survival Analysis
• ISSN: 0936-8051; 1434-3916
• DOI: 10.1007/s00402-007-0551-0

Introduction The Estimation of Physiologic Ability and Surgical Stress (E-PASS) scoring system is comprised of a preoperative risk score (PRS), a surgical stress score (SSS), and a comprehensive risk score (CRS) determined by both the PRS and SSS. E-PASS predicts the postoperative risk by quantifying the patient’s reserve and surgical stress in general surgery. This study aims to evaluate the usefulness of this scoring system for the hospitalization outcomes in hip fracture. Patients and methods A consecutive series of 419 elderly patients who underwent surgery with osteosynthesis or arthroplasty for hip fracture were prospectively assessed for the E-PASS scoring system, which was compared with their postoperative course. Results The postoperative morbidity and mortality rates in hospital increased linearly as the PRS and CRS increased, with significant correlation ( ρ  = 0.2, P