Using the E-PASS scoring system to estimate the risk

of emergency abdominal surgery in patients with

acute gastrointestinal disease
Authors
Authors and affiliations
 Kenichi Koushi
 Daisuke Korenaga
 Hirofumi Kawanaka
 Toshirou Okuyama
 Yasuharu Ikeda
 Kenji Takenaka

Original Article

First Online: 04 October 2011

Purpose
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.
 Key words
Emergency operation Gastrointestinal disease Postoperative complication

This paper was presented at the 62nd Annual Meeting of the Japanese
Society of Gastroenterological Surgery in Tokyo, Japan, on July 19, 2007.

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