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Archives of Orthopaedic and Trauma Surgery

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01.12.2008 | Orthopaedic Outcome Assessment

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

verfasst von: J. Hirose, H. Mizuta, J. Ide, K. Nomura

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 12/2008

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Abstract

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 < 0.01) in both operations. The cost of hospital stay also related significantly to the SSS (r = 0.6, P < 0.0001) and CRS (r = 0.4, P < 0.0001).

Conclusion

These results suggest that E-PASS may be useful for predicting postoperative risk and estimating medical expense for surgical cases with hip fracture.

Alberti KG, Zimmet PZ (1998) Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med 15:539–553PubMedCrossRef

Committee for Osteoporosis Treatment of The Japanese Orthopaedic Association (2004) Nationwide survey of hip fractures in Japan. J Orthop Sci 9:1–5CrossRef

Copeland GP, Jones D, Walters M (1991) POSSUM: a scoring system for surgical audit. Br J Surg 78:355–360PubMedCrossRef

Donati A, Ruzzi M, Adrario E, Pelaia P, Coluzzi F, Gabbanelli V, Pietropaoli P (2004) A new and feasible model for predicting operative risk. Br J Anaesth 93:393–399PubMedCrossRef

Dorotka R, Schoechtner H, Buchinger W (2003) The influence of immediate surgical treatment of proximal femoral fractures on mortality and quality of life. Operation within six hours of the fracture versus later than six hours. J Bone Joint Surg Br 85:1107–1113PubMedCrossRef

Doruk H, Mas MR, Yildiz C, Sonmez A, Kyrdemir V (2004) The effect of the timing of hip fracture surgery on the activity of daily living and mortality in elderly. Arch Gerontol Geriatr 39:179–185PubMedCrossRef

Elliott J, Beringer T, Kee F, Marsh D, Willis C, Stevenson M (2003) Predicting survival after treatment for fracture of the proximal femur and the effect of delays to surgery. J Clin Epidemiol 56:788–795PubMedCrossRef

Gdalevich M, Cohen D, Yosef D, Tauber C (2004) Morbidity and mortality after hip fracture: the impact of operative delay. Arch Orthop Trauma Surg 124:334–340PubMedCrossRef

Goldman L, Caldera DL, Nussbaum SR, Southwick FS, Krogstad D, Murray B, Burke DS, O’Malley TA, Goroll AH, Caplan CH, Nolan J, Carabello B, Slater EE (1977) Multifactorial index of cardiac risk in noncardiac surgical procedures. N Engl J Med 297:845–850PubMedCrossRef

10.

Haga Y, Ikei S, Ogawa M (1999) Estimation of Physiologic Ability and Surgical Stress (E-PASS) as a new prediction scoring system for postoperative morbidity and mortality following elective gastrointestinal surgery. Surg Today 29:219–225PubMedCrossRef

11.

Haga Y, Yagi Y, Ogawa M (1999) Less-invasive surgery for gastric cancer prolongs survival in patients over 80 years of age. Surg Today 29:842–848PubMedCrossRef

12.

Hagino H, Yamamoto K, Ohshiro H, Nakamura T, Kishimoto H, Nose T (1999) Changing incidence of hip, distal radius, and proximal humerus fractures in Tottori Prefecture, Japan. Bone 24:265–270PubMedCrossRef

13.

Jiang HX, Majumdar SR, Dick DA, Moreau M, Raso J, Otto DD, Johnston DW (2005) Development and initial validation of a risk score for predicting in-hospital and 1-year mortality in patients with hip fractures. J Bone Miner Res 20:494–500PubMedCrossRef

14.

Kenzora JE, McCarthy RE, Lowell JD, Sledge CB (1984) Hip fracture mortality. Relation to age, treatment, preoperative illness, time of surgery, and complications. Clin Orthop Relat Res 186:45–56PubMed

15.

Knaus WA, Draper EA, Wagner DP, Zimmerman JE (1985) APACHE II: a severity of disease classification system. Crit Care Med 13:818–829PubMedCrossRef

16.

Masuda T, Miura N, Ishii S, Hibino Y, Beppu M (2004) New preoperative evaluation system of the physical findings of aged patients with femoral neck fracture. J Orthop Sci 9:434–439PubMedCrossRef

17.

McGuire KJ, Bernstein J, Polsky D, Silber JH (2004) The 2004 Marshall Urist award: delays until surgery after hip fracture increases mortality. Clin Orthop Relat Res 428:294–301PubMedCrossRef

18.

Oka Y, Nishijima J, Oku K, Azuma T, Inada K, Miyazaki S, Nakano H, Nishida Y, Sakata K, Izukura M (2005) Usefulness of an estimation of physiologic ability and surgical stress (E-PASS) scoring system to predict the incidence of postoperative complications in gastrointestinal surgery. World J Surg 29:1029–1033PubMedCrossRef

19.

Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5:649–655PubMedCrossRef

20.

Owens WD, Felts JA, Spitznagel EL Jr (1978) ASA physical status classifications: a study of consistency of ratings. Anesthesiology 49:239–243PubMedCrossRef

21.

Wehren LE, Hawkes WG, Orwig DL, Hebel JR, Zimmerman SI, Magaziner J (2003) Gender differences in mortality after hip fracture: the role of infection. J Bone Miner Res 18:2231–2237PubMedCrossRef

22.

Winter WG (1987) Nonoperative treatment of proximal femoral fractures in the demented, nonambulatory patient. Clin Orthop Relat Res 218:97–103PubMed

23.

Yamashita S, Haga Y, Nemoto E, Nagai S, Ohta M (2004) E-PASS (the estimation of physiologic ability and surgical stress) scoring system helps the prediction of postoperative morbidity and mortality in thoracic surgery. Eur Surg Res 36:249–255PubMedCrossRef

24.

Zuckerman JD, Skovron ML, Koval KJ, Aharonoff G, Frankel VH (1995) Postoperative complications and mortality associated with operative delay in older patients who have a fracture of the hip. J Bone Joint Surg Am 77:1551–1556PubMed

Titel: Evaluation of estimation of physiologic ability and surgical stress (E-PASS) to predict the postoperative risk for hip fracture in elder patients
verfasst von: J. Hirose
H. Mizuta
J. Ide
K. Nomura
Publikationsdatum: 01.12.2008
Verlag: Springer-Verlag
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 12/2008
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-007-0551-0

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Conclusion

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