title: Evaluation of estimation of physiologic ability and surgical stress (E-PASS) to predict the postoperative risk for hip fracture in elder patients.
abstract: BACKGROUND
  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.
  
  
  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 (rho = 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).
  
  
  CONCLUSIONS
  These results suggest that E-PASS may be useful for predicting postoperative risk and estimating medical expense for surgical cases with hip fracture.
authors.affiliation: Department of Orthopaedic and Neuro-Musculoskeletal Surgery, Faculty of Medical and Phamaceutical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto 860-8556, Japan. hirojun-mk@umin.ac.jp
authors.forename: J
authors.initials: J
authors.lastname: Hirose
authors.forename: H
authors.initials: H
authors.lastname: Mizuta
authors.forename: J
authors.initials: J
authors.lastname: Ide
authors.forename: K
authors.initials: K
authors.lastname: Nomura
mesh_terms: D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000379:methods / Q000401:mortality / Q000523:psychology*; D017102:Fracture Healing / Q000502:physiology*; D015577:Geriatric Assessment; D006305:Health Status Indicators; D006620:Hip Fractures / Q000401:mortality / Q000523:psychology / Q000601:surgery*; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality / Q000523:psychology*; D011237:Predictive Value of Tests; D011336:Probability; D011446:Prospective Studies; D020127:Recovery of Function; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D013312:Stress, Physiological; D016019:Survival Analysis