The use of the E-PASS scoring system in determining complication development in patients with isolated acetabular fractures.

Fairhurst, Paul Gilbert; Tsinas, Dionysios; Correa Shokiche, Carlos; Keel, Marius Johann Baptist; Siebenrock, Klaus Arno; Bastian, Johannes Dominik (2020). The use of the E-PASS scoring system in determining complication development in patients with isolated acetabular fractures. (In Press). European journal of trauma and emergency surgery Springer-Medizin-Verlag 10.1007/s00068-020-01395-0

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BACKGROUND

The decision to treat acetabular fractures is occasionally deferred or foregone in patients perceived to be unfit for surgery. The previously validated estimation of physiologic ability and surgical stress (E-PASS) score has been shown to predict outcome in a variety of fractures, and consists of a preoperative risk score (PRS), a surgical stress score (SSS), and a comprehensive risk score (CRS).

PURPOSE

To correlate E-PASS and its components with postoperative complication to quantify risk for individual surgical and patient factors in acetabular fracture management.

METHODS

A retrospective review of patient records was performed for all patients with acetabular fractures surgically treated between January 2013 and June 2018 in a level 1 Trauma Centre. Patients with multiple injuries and/or malignancies were excluded. E-PASS scores were determined with standard demographic data and subscores were correlated with complication development.

RESULTS

Of the included 106 patients (mean age 61 years, range 17-93), complications were reported in 37 (34.9%) patients and 3 (2.8%) died. Hospital postoperative morbidity and mortality rates increased significantly with the PRS and CRS. The SSS did not correlate significantly with frequency of complications. Age was found to be the only significant independent risk factor (p value = 0.031, OR = 1.03 per year of age).

CONCLUSION

Latent patient factors have a clear influence on adverse outcomes in contrast to controllable factors such as surgical stress indicating an important role for perioperative care in reducing postoperative complications. Integrated orthogeriatric care with assessment of comorbidities, prevention or early recognition, and treatment of perioperative complications is essential.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Anatomy

UniBE Contributor:

Fairhurst, Paul Gilbert Arthur Penn; Tsinas, Dionysios; Correa Shokiche, Carlos; Keel, Marius; Siebenrock, Klaus-Arno and Bastian, Johannes Dominik

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1863-9933

Publisher:

Springer-Medizin-Verlag

Language:

English

Submitter:

Kathrin Aeschlimann

Date Deposited:

26 Nov 2020 11:59

Last Modified:

26 Nov 2020 11:59

Publisher DOI:

10.1007/s00068-020-01395-0

PubMed ID:

32447403

Uncontrolled Keywords:

Acetabular fracture Complication E-PASS Morbidity Mortality Orthogeriatric Risk

BORIS DOI:

10.7892/boris.148529

URI:

https://boris.unibe.ch/id/eprint/148529

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