Department of Visceral Surgery and Medicine, Inselspital, University Hospital Berne and University of Berne, Berne, Switzerland.
Pancreas. 2011 Jul;40(5):723-9. doi: 10.1097/MPA.0b013e318212c02c.
The Estimation of Physiologic Ability and Surgical Stress score was designed to predict postoperative morbidity and mortality in general surgery. Our study aims to evaluate its use and accuracy in estimating postoperative outcome after elective pancreatic surgery.
Between 2002 and 2007, approximately 304 patients requiring pancreatic resection at our institution were recorded prospectively and evaluated retrospectively. The patients' preoperative risk score, surgical stress score (SSS), and comprehensive risk score (CRS) were calculated and compared with the severity of postoperative morbidity, where mortality was regarded as the most severe postoperative complication.
Observed and predicted mortality rates were 2.9% and 2.0%, respectively. Mean CRS was higher in patients who died than in patients that survived, but this difference was not statistically significant (P = 0.20). Preoperative risk score, SSS, and CRS did not differ between patients with and without complications (preoperative risk score: P = 0.32; SSS: P = 0.22; CRS: P = 0.13). Estimation of Physiologic Ability and Surgical Stress particularly underpredicted morbidity in patients with a CRS between 0.0 and less than 0.5.
The Estimation of Physiologic Ability and Surgical Stress scoring system is an ineffective predictor of complications after pancreatic resection. Further refinements to the score calculation are warranted to provide accurate prediction of immediate surgical outcome after pancreatic surgery.
生理能力和手术应激评分的估测旨在预测普通外科的术后发病率和死亡率。我们的研究旨在评估其在预测择期胰腺手术后术后结果的使用和准确性。
在 2002 年至 2007 年期间，我们机构大约有 304 名需要胰腺切除术的患者被前瞻性记录并回顾性评估。计算了患者的术前风险评分、手术应激评分（SSS）和综合风险评分（CRS），并与术后严重发病率进行比较，其中死亡率被视为最严重的术后并发症。
观察到和预测的死亡率分别为 2.9%和 2.0%。死亡患者的平均 CRS 高于存活患者，但差异无统计学意义（P=0.20）。术前风险评分、SSS 和 CRS 在无并发症和有并发症的患者之间没有差异（术前风险评分：P=0.32；SSS：P=0.22；CRS：P=0.13）。生理能力和手术应激评分尤其是在 CRS 为 0.0 到 0.5 之间的患者中，对发病率的预测过低。
生理能力和手术应激评分系统是胰腺切除术后并发症的无效预测因子。需要进一步改进评分计算，以提供胰腺手术后即时手术结果的准确预测。
