title: Using the E-PASS scoring system to estimate the risk of emergency abdominal surgery in patients with acute gastrointestinal disease.
abstract: OBJECTIVE
  The Estimation of Physiologic Ability and Surgical Stress (E-PASS) scoring system, which quantifies a patient's reserve and surgical stress, is used to predict morbidity and mortality in patients before elective gastrointestinal surgery. We conducted this study to clarify whether the E-PASS scoring system is useful for assessing the risks of emergency abdominal surgery.
  
  
  METHODS
  The subjects of this retrospective study were 51 patients who underwent emergency gastrointestinal surgery at a public general hospital. The main outcomes were the E-PASS scores and the postoperative course, defined by mortality and morbidity.
  
  
  RESULTS
  Postoperative complications developed in 15 of the 51 patients (29.4%). The E-PASS score was significantly higher in the patients with postoperative complications than in those without (0.61 ± 0.31 vs 0.20 ± 0.35, respectively; n = 36). The morbidity rates were significantly lower in the patients with a value less than 0.5 than in those with a value more than 0.5 (17.1% and 56.3%, respectively; P < 0.01). There were 7 operative deaths among the 16 patients with a high score, versus none among the 9 patients with a low score (P < 0.01). Three patients underwent laparoscopic-assisted bowel resection with a good postoperative course, with scores of less than 0.5.
  
  
  CONCLUSIONS
  The E-PASS scoring system is useful for surgical decision making and evaluating whether patients will tolerate emergency gastrointestinal surgery. Minimally invasive therapy would assist in lowering the risk of complications.
authors.affiliation: Department of Surgery, Fukuoka City Hospital, 13-1 Yoshizukahonmachi, Hakata-ku, Fukuoka, 812-0046, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Koushi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Korenaga
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kawanaka
authors.forename: Toshirou
authors.initials: T
authors.lastname: Okuyama
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Kenji
authors.initials: K
authors.lastname: Takenaka
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis / Q000601:surgery*; D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D015331:Cohort Studies; D016638:Critical Illness; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D004638:Emergency Treatment / Q000379:methods*; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011379:Prognosis; D012189:Retrospective Studies; D012737:Sex Factors; D013315:Stress, Psychological; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult