E-PASS for predicting postoperative risk with hip fracture: a multicenter study.

UNLABELLED: This multicenter study of 813 consecutive patients with hip fracture was performed to estimate the effectiveness and reproducibility of the Estimation of Physiologic Ability and Surgical Stress (E-PASS) scoring system to assess postoperative risk in patients with hip fracture. E-PASS is comprised of a preoperative risk score, a surgical stress score, and a comprehensive risk score based on the preoperative risk score and surgical stress score. Postoperative complications developed in 163 patients (20.0%); 13 (1.6%) died. Hospital postoperative morbidity and mortality rates increased linearly with the preoperative risk score and comprehensive risk score; the correlation was significant. The severity of postoperative complications and the incidence of higher grades of complications increased significantly with rising preoperative risk score and comprehensive risk score. Each E-PASS score also was related significantly with the length of postoperative hospitalization and costs. These results suggest E-PASS is useful for predicting postoperative risk, estimating costs, and for comparing the outcome in patients having surgical treatment of hip fractures. LEVEL OF EVIDENCE: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.