Ishihata Kiyohide, Kakihana Yasuyuki, Yoshimura Takuya, Murakami Juri, Toyodome Soichiro, Hijioka Hiroshi, Nozoe Etsuro, Nakamura Norifumi
1Department of Oral and Maxillofacial Surgery, Field of Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544 Japan.
2Department of Emergency and Intensive Care Medicine, Faculty of Medicine, Kagoshima University, Kagoshima, Japan.
Patient Saf Surg. 2018 Apr 5;12:3. doi: 10.1186/s13037-018-0152-6. eCollection 2018.
The prediction of postoperative complications is important for oral and maxillofacial surgeons. We herein aimed to evaluate the efficacy of the Estimation of Physiologic Ability and Surgical Stress (E-PASS) and Acute Physiology, Age, and Chronic Health Evaluation (APACHE) II scoring systems to predict postoperative complications in patients undergoing oral and maxillofacial surgery.
Thirty patients (22 males, 8 females; mean age: 65.1 ± 12.9 years) who underwent major oral surgeries and stayed in the intensive care unit for postoperative management were enrolled in this study. Postoperative complications were discriminated according to the necessity of the therapeutic intervention by the Medical Department, i.e. according to the Clavien-Dingo classification. E-PASS and APACHE II scores as well as laboratory test values were compared between patients with/without postoperative complications.
Postoperative complications were developed in seven patients. The comprehensive risk score (CRS: 1.13 ± 0.24) and APACHE II score (13.0 ± 2.58) were significantly higher in patients with postoperative complications than in those without ones ( < 0.01, < 0.05, respectively). The CRS showed an appropriate discriminatory power for predicting postoperative complications (area under the curve: 0.814). Furthermore, a correlation was detected between APACHE II scores and postoperative data until C-reactive protein levels decreased to < 1.0 mg/L ( = 0.43, < 0.05).
The E-PASS and APACHE II scoring systems were both shown to be useful to predict postoperative complications after oral and maxillofacial surgery.
术后并发症的预测对于口腔颌面外科医生而言至关重要。我们旨在评估生理能力与手术应激评估（E-PASS）及急性生理与慢性健康状况评分系统（APACHE）II对口腔颌面外科手术患者术后并发症的预测效果。
本研究纳入30例接受大型口腔手术并入住重症监护病房进行术后管理的患者（22例男性，8例女性；平均年龄：65.1±12.9岁）。根据内科治疗干预的必要性，即根据Clavien-Dindo分类法来区分术后并发症。比较有/无术后并发症患者的E-PASS和APACHE II评分以及实验室检查值。
7例患者出现术后并发症。有术后并发症患者的综合风险评分（CRS：1.13±0.24）和APACHE II评分（13.0±2.58）显著高于无并发症患者（分别为<0.01，<0.05）。CRS对预测术后并发症具有适当的鉴别能力（曲线下面积：0.814）。此外，在C反应蛋白水平降至<1.0 mg/L之前，检测到APACHE II评分与术后数据之间存在相关性（r = 0.43，P<0.05）。
E-PASS和APACHE II评分系统均显示对预测口腔颌面外科手术后的并发症有用。
