Tetsuro Tominaga1, Hiroaki Takeshita1, Katsunori Takagi1, Masaki Kunizaki1, Kazuo To1, Takafumi Abo1, Shigekazu Hidaka1, Atsushi Nanashima1,2, Takeshi Nagayasu1, Terumitsu Sawai3,4. 1. Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan. 2. Division of Surgical Oncology and Regulation of Organ Function, Miyazaki University Graduate School of Medicine, Miyazaki, Japan. 3. Department of Health Science, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan. sawai@nagasaki-u.ac.jp. 4. Division of Surgical Oncology, Department of Health Science, Nagasaki University Graduate School of Biological Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. sawai@nagasaki-u.ac.jp.
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.
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.
Entities:
Keywords:
Colorectal cancer; Elderly patient; Estimation of physiologic ability and surgical stress (E-PASS); Surgery
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