E-PASS for Predicting Postoperative Risk with Hip Fracture: A Multicenter Study

Jun Hirose MD, PhD, Hiroshi Mizuta MD, PhD, Junji Ide MD, PhD, Eiichi Nakamura MD, PhD, Koji Takada MD
Original Article
Volume 466, Issue 11 / November , 2008

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Abstract

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.

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