This multicenter study of 813 consecutive patients with hip fracture was performed to estimate the effectiveness and reproducibility
of the Estimation of Physiologic Ability and Surgical Stress (E-PASS) scoring system to assess postoperative risk in patients
with hip fracture. E-PASS is comprised of a preoperative risk score, a surgical stress score, and a comprehensive risk score
based on the preoperative risk score and surgical stress score. Postoperative complications developed in 163 patients (20.0%);
13 (1.6%) died. Hospital postoperative morbidity and mortality rates increased linearly with the preoperative risk score and
comprehensive risk score; the correlation was significant. The severity of postoperative complications and the incidence of
higher grades of complications increased significantly with rising preoperative risk score and comprehensive risk score. Each
E-PASS score also was related significantly with the length of postoperative hospitalization and costs. These results suggest
E-PASS is useful for predicting postoperative risk, estimating costs, and for comparing the outcome in patients having surgical
treatment of hip fractures.
Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
One of the authors (JH) has received funding from a research grant for the policy-based medical services network for musculoskeletal
diseases (Number 771).
Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations
were conducted in conformity with ethical principles of research.