ASSESSING E-PASS [THE ESTIMATION OF PHYSIOLOGIC ABILITY AND SURGICAL STRESS] SCORING SYSTEM AS A PREDICTOR OF POST OPERATIVE MORBIDITY

Surgery alters the homeostatic balance and defence mechanisms in body eliciting certain responses called as stress response. In addition certain peri operative factors like post operative pain and psychological factors may also influence the degree of stress response reflecting surgical recovery. The present study is an attempt to estimate the effectiveness of E-PASS scoring system to assess the post operative risk by quantifying patients reserve and degree of surgical stress. . Surgical stress scoring system [E-PASS] is comprised of a pre operative risk score, a surgical stress score and comprehensive risk score. There have been a few reports of use of the E-PASS scoring system to assess the risk of mortality following special types of surgical procedures and it has been proposed as a means of predicting postoperative complications In the present study the incidence of post operative complications increased significantly with rising preoperative risk score and comprehensive risk score and was also significantly related with the length of stay. We found E-PASS scoring system beneficial for predicting the post operative complications and considering the perioperative factors. Thus we suggest that E-PASS scoring system may be useful in surgical decision making, predicting post operative risk and evaluating quality of care. Key Words: Stress response, E-PASS, Homeostasis, postoperative risk