| 刘明富 董辉 董海龙 熊利泽 路志红.E-PASS评分系统用于评估老龄患者消化道手术后并发症和转归的
临床价值研究[J].,2014,14(34):6658-6660 |
| E-PASS评分系统用于评估老龄患者消化道手术后并发症和转归的
临床价值研究 |
| Clinical Value of E-PASS Systemin the Evaluation of the PostoperativeComplications and Outcomes of Elderly Patients Undergoing DigestiveSurgery |
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| DOI： |
| 中文关键词: 老龄患者 消化道手术 日常活动和手术应激评估 术前风险评分 综合风险评分 |
| 英文关键词: Aged patients Digestive surgery Estimation of physiologic ability and surgical stress (E-PASS) Preoperative risk score
(PRS) Comprehensive risk score (CRS) |
| 基金项目:陕西省科技计划项目（2012SF2-01-6）；国家自然科学基金项目（81070966） |
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| 中文摘要: |
| 目的：评价日常活动和手术应激评估(Estimation of physiologic ability and surgical stress, E-PASS)系统用于评估老龄患者消化
道手术后并发症和转归的临床价值。方法：回顾性分析2011 年7 月至2013年7 月西京医院消化外科所有65 岁以上的患者的临
床资料，计算其中行消化道手术者的E-PASS 评分，并记录这些患者术后并发症的发生情况和患者术后的住院时间。分析E-PASS
评分和几项该评分未涉及的因素与老龄患者消化道手术后并发症的发病率、死亡率、住院时间的相关性。结果：研究共纳入1236
例老龄行消化道手术的患者，其中521 例发生术后并发症(42.15%)，8 例死亡(0.65%)。患者术前E-PASS 评分系统中，三项评分均
与术后住院时间相关，术前风险评分(Preoperative risk score，PRS)和综合风险评分(Comprehensive risk score，CRS)与术后并发症的
发病率和死亡率显著相关(P 均<0.05)。E-PASS 评分系统未包含的指标中，麻醉方法与术后并发症发生和住院时间无关，术后入
ICU、术中使用血管活性药物和急诊手术与术后发病率、死亡率和住院时间相关(P 均<0.05)。结论：E-PASS评分系统可用于预测
老龄患者行消化道手术后并发症的发生情况和转归，纳入术后入ICU、术中使用血管活性药物和急诊手术三项指标可能进一步提
高E-PASS 评分系统的预测准确性。 |
| 英文摘要: |
| Objective:To assess the cliniacl value of Estimation of physiologic ability and surgical stress (E-PASS) system in the
evaluation of the postoperative complications and outcomes of elderly patients undergoing digestive surgery.Methods:Patients>65 yrs
old who underwent digestive surgery in Xijing hospital from July 2011 to July 2013 were enrolled. E-PASS scores were used to calculate
for each patient. Complications and postoperativehospital stay were recorded. The relationships between E-PASS scores or some optional
risk factors and morbidity, mortality or hospital stay were analyzed.Results:1236 patients underwent digestive surgery were analyzed, in
which 521 suffered from complications (42.15%), 8 were dead (0.65%). All the three scores of E-PASS were related to hospital stay
postoperatively, while only preoperative risk score (PRS) and comprehensive risk score (CRS) were related to the postoperative morbidity
and mortality (all P<0.05). Anesthetic technique (inhaled or intravenous) was not related to postoperative outcomes. However,
transportation to ICU, use of vasoactive agents during the surgery and emergency cases was related to morbidity, mortality and hospital
stay (all P<0.05).Conclusion:E-PASS scoring system could predict the postoperative outcome of elderly patients undergoing digestive
surgery. Integrating admission in ICU, use of vasoactive agents during the surgery and emergency case into the system might improve its
accuracy. |
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