Evaluation of Estimation of Physiologic Ability and Surgical Stress (E-PASS) in Elderly Patients with Colorectal Cancer

Daisuke Inagaki, Shinichi Hasegawa, Tatsuya Yoshida, Tomohiko Osaragi, Katsuya Yoneyama, Akio Kasahara and Yuji Yamamoto

Department of Surgery, Kanagawa Prefectural Ashigarakami Hospital

Introduction: We discussed postoperative-complication risk factors and evaluated the usefulness of Estimation of Physiologic Ability and Surgical Stress (E-PASS) in predicting postoperative complication in elderly patients with colorectal cancer. Methods: We studied clinicopathological features and postoperative complications in 82 patients over age 75 who underwent colorectal cancer surgery from 2002 to 2007. Based on E-PASS, preoperative risk score (PRS), surgical stress score (SSS), and comprehensive risk score (CRS), we calculated from physiological factors and operative severity, we evaluated the relationship between postoperative complications and E-PASS. Results: Patients were divided into Group A-46 patients without postoperative complications- and Group B-36 patients with postoperative complications. PRS, SSS, and CRS were higher in Group B than Group A. Patients with CRS≥0.5 numbered significantly more in Group B than in Group A, significantly more had perforation, undernutrition, PS of 2 to 3, ASA classification of 3 to 4. Multivariate analysis indicated that CRS≥0.5 was the most important risk factor for postoperative complications. Discussion: E-PASS appears to be useful in predicting postoperative risk in elderly patients with colorectal cancer.

Key words
colorectal cancer in elderly patients, postoperative complications, E-PASS

Reprint requests
Daisuke Inagaki Department of Surgery, Kanagawa Prefectural Ashigarakami Hospital
866-1 Matsudasouryou, Matsudachou, Ashigarakami-gun, 258-0003 JAPAN

Accepted
June 18, 2009

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