Comparison of surgical outcome using the prediction scoring system of E-PASS for thoracic surgery.
OBJECTIVE
The purpose of this study was to determine if our predictive scoring system, E-PASS, can estimate the surgical outcome.


METHODS
We conducted a multicenter cohort study for 3 years in four national hospitals. A consecutive series of 731 patients who underwent elective thoracic operations were analyzed. The preoperative risk score (PRS) and the comprehensive risk score (CRS) of the E-PASS were determined preoperatively and immediately after the operation, respectively. The cost of the surgical admission and the severity of the postoperative complications were recorded at the time of discharge.


RESULTS
The CRS significantly correlated with the severity of the postoperative complications (rs = 0.728, P < 0.0001) and the charge (rs = 0.530, P< 0.0001). When the estimated/real morbidity ratio (MR) among the hospitals was compared, it varied from 0.16 to 0.59. A significant increase in the cost was observed according to the CRS.


CONCLUSIONS
The E-PASS scoring system may be useful for standardizing the patient population and surgical severity to compare the surgical outcome.
Yamashita
Shin-ichi
S
Department of Surgery, National Hospital Organization, Kumamoto Medical Center, Japan. yamashin@kumamoto2.hosp.go.jp
Haga
Yoshio
Y
Nemoto
Etsuo
E
Imanishi
Naoko
N
Ohta
Morio
M
Kawahara
Katsunobu
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D017558:Elective Surgical Procedures / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology*; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013312:Stress, Physiological; D019616:Thoracic Surgical Procedures / Q000191:economics; D016896:Treatment Outcome