Validity of E-PASS Score for Evaluating Perioperative Minor Complications Associated with Carotid Endarterectomy

Carotid endarterectomy (CEA) is conducted to reduce the risk of cerebral infarction; therefore, a low complication rate is highly required. To predict long-term morbidity and mortality, various scoring systems have been considered; nonetheless, a model that can be utilized to estimate nonmajor tempo...

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Main Authors: Yutaka MORISHIMA, Masahito KAWABORI, Yoichi ITO, Masayuki GEKKA, Koji FURUKAWA, Yoshimasa NIIYA, Miki FUJIMURA
Format: Article
Language:English
Published: The Japan Neurosurgical Society 2025-01-01
Series:Neurologia Medico-Chirurgica
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Online Access:https://www.jstage.jst.go.jp/article/nmc/65/1/65_2024-0035/_pdf/-char/en
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author Yutaka MORISHIMA
Masahito KAWABORI
Yoichi ITO
Masayuki GEKKA
Koji FURUKAWA
Yoshimasa NIIYA
Miki FUJIMURA
author_facet Yutaka MORISHIMA
Masahito KAWABORI
Yoichi ITO
Masayuki GEKKA
Koji FURUKAWA
Yoshimasa NIIYA
Miki FUJIMURA
author_sort Yutaka MORISHIMA
collection DOAJ
description Carotid endarterectomy (CEA) is conducted to reduce the risk of cerebral infarction; therefore, a low complication rate is highly required. To predict long-term morbidity and mortality, various scoring systems have been considered; nonetheless, a model that can be utilized to estimate nonmajor temporary complications and minor complications is currently lacking. To evaluate the occurrence rate of perioperative complications in various surgical domains, the E-PASS (Estimation of Physiological Ability and Surgical Stress) score is employed. This study was carried out to investigate the utility of the E-PASS score as a predictive factor for the risk of minor complications in patients undergoing CEA. The retrospective analysis was performed for 104 consecutive series of CEA procedures carried out at Otaru Municipal Hospital. The correlation between E-PASS and the rate of minor complications was examined. Sensitivity and specificity were used to construct a receiver operating characteristic curve, and the area under the curve (AUC) was calculated for accuracy. Postoperative minor complications occurred in eight cases (7.7%), including six vagal nerve injuries and two pneumonia cases. Three categorical data-preoperative risk score, surgical stress scores, and comprehensive risk score (CRS)-showed a good relationship with the postoperative minor complication. Among them, CRS presented the highest sensitivity and specificity, as indicated by an AUC of 0.68. The CRS cutoff value was calculated as −0.068, with a 1.7% postoperative minor complication rate for those lower than −0.068 and 14.0% for those higher than −0.068. The E-PASS score was effective for evaluating and predicting postoperative minor complications in patients with CEA procedures.
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spelling doaj-art-0df5431adf5140a4b7548f4d27cc76d52025-02-10T05:22:30ZengThe Japan Neurosurgical SocietyNeurologia Medico-Chirurgica1349-80292025-01-0165191410.2176/jns-nmc.2024-00352024-0035Validity of E-PASS Score for Evaluating Perioperative Minor Complications Associated with Carotid EndarterectomyYutaka MORISHIMA0Masahito KAWABORI1Yoichi ITO2Masayuki GEKKA3Koji FURUKAWA4Yoshimasa NIIYA5Miki FUJIMURA6Department of Neurosurgery, Graduate School of Medicine, Hokkaido UniversityDepartment of Neurosurgery, Graduate School of Medicine, Hokkaido UniversityInstitute of Health Science Innovation for Medical Care, Biostatistics Division, Hokkaido University HospitalDepartment of Neurosurgery, Otaru General HospitalDepartment of Neurosurgery, Otaru General HospitalDepartment of Neurosurgery, Otaru General HospitalDepartment of Neurosurgery, Graduate School of Medicine, Hokkaido UniversityCarotid endarterectomy (CEA) is conducted to reduce the risk of cerebral infarction; therefore, a low complication rate is highly required. To predict long-term morbidity and mortality, various scoring systems have been considered; nonetheless, a model that can be utilized to estimate nonmajor temporary complications and minor complications is currently lacking. To evaluate the occurrence rate of perioperative complications in various surgical domains, the E-PASS (Estimation of Physiological Ability and Surgical Stress) score is employed. This study was carried out to investigate the utility of the E-PASS score as a predictive factor for the risk of minor complications in patients undergoing CEA. The retrospective analysis was performed for 104 consecutive series of CEA procedures carried out at Otaru Municipal Hospital. The correlation between E-PASS and the rate of minor complications was examined. Sensitivity and specificity were used to construct a receiver operating characteristic curve, and the area under the curve (AUC) was calculated for accuracy. Postoperative minor complications occurred in eight cases (7.7%), including six vagal nerve injuries and two pneumonia cases. Three categorical data-preoperative risk score, surgical stress scores, and comprehensive risk score (CRS)-showed a good relationship with the postoperative minor complication. Among them, CRS presented the highest sensitivity and specificity, as indicated by an AUC of 0.68. The CRS cutoff value was calculated as −0.068, with a 1.7% postoperative minor complication rate for those lower than −0.068 and 14.0% for those higher than −0.068. The E-PASS score was effective for evaluating and predicting postoperative minor complications in patients with CEA procedures.https://www.jstage.jst.go.jp/article/nmc/65/1/65_2024-0035/_pdf/-char/encarotid endarterectomycomplicationscoringprediction
spellingShingle Yutaka MORISHIMA
Masahito KAWABORI
Yoichi ITO
Masayuki GEKKA
Koji FURUKAWA
Yoshimasa NIIYA
Miki FUJIMURA
Validity of E-PASS Score for Evaluating Perioperative Minor Complications Associated with Carotid Endarterectomy
Neurologia Medico-Chirurgica
carotid endarterectomy
complication
scoring
prediction
title Validity of E-PASS Score for Evaluating Perioperative Minor Complications Associated with Carotid Endarterectomy
title_full Validity of E-PASS Score for Evaluating Perioperative Minor Complications Associated with Carotid Endarterectomy
title_fullStr Validity of E-PASS Score for Evaluating Perioperative Minor Complications Associated with Carotid Endarterectomy
title_full_unstemmed Validity of E-PASS Score for Evaluating Perioperative Minor Complications Associated with Carotid Endarterectomy
title_short Validity of E-PASS Score for Evaluating Perioperative Minor Complications Associated with Carotid Endarterectomy
title_sort validity of e pass score for evaluating perioperative minor complications associated with carotid endarterectomy
topic carotid endarterectomy
complication
scoring
prediction
url https://www.jstage.jst.go.jp/article/nmc/65/1/65_2024-0035/_pdf/-char/en
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