Table 1 Estimation of Physiologic Ability and Surgical Stress (E-PASS) and Acute Physiology and Chronic Health Evaluation (APACHE) II scoring systems
The E-PASS score consists of three parts for estimation of physiologic ability (PRS), surgical stress (SSS), and their comprehensive score(CRS). The formula for each score was as follows: | |||||||||
PRS = − 0.0686 + 0.00345X1 + 0.323X2 + 0.205X3 + 0.153X4 + 0.148X5 + 0.0666X6 | |||||||||
XI: age | |||||||||
X2: absence (0) or presence (1) of severe heart disease | |||||||||
X3: absence (0) or presence (I) of severe pulmonary disease | |||||||||
X4: absence (0) or presence (I) of diabetes mellitus | |||||||||
X5: performance status index (0–4) | |||||||||
X6: American Society of Anesthesiologists physiological status classification (1–5) | |||||||||
SSS = − 0.342 + 0.0139X1 + 0.0392X2 + 0.352X3 | |||||||||
XI: blood loss/body weight (g/kg) | |||||||||
X2: Operative time (hours) | |||||||||
X3: Extent of the skin incision (0: minor incision, 1: laparotomy or thoracotomy alone, 2: both laparotomy and thoracotomy) | |||||||||
CRS = − 0.328 + 0.396(PRS) + 0.976(SSS) | |||||||||
The APACHE II score is the sum of the acute physiology score (vital signs, oxygenation, laboratory values), the Glasgow coma score, age, and Choronic health points. The worst values during the first 24 h in the ICU should be used. Glasgow coma score(GCS) = eye-openig score + veabal score (intubated or nonintubated) score + motor score. For CCS component of acute physiology score, subtract GCS from 15 to obtain points assigned. | |||||||||
Acute Physiology Score | |||||||||
Score | 4 | 3 | 2 | 1 | 0 | 1 | 2 | 3 | 4 |
Rectal temperature (°C) | ≥41 | 39.0~ 40.9 | 38.5~ 38.9 | 36.0~ 38.4 | 34.0~ 35.9 | 32.0~ 33.9 | 30.0~ 31.9 | ≤29.9 | |
Mean blood pressure (mmHg) | ≥160 | 130~ 159 | 110~ 129 | 70~ 109 | 50~ 69 | ≤49 | |||
Heart rate (beat/min) | ≥180 | 140~ 179 | 110~ 139 | 55~ 69 | 40~ 54 | ≤39 | |||
Respiratory rate (breaths/min) | ≥50 | 35~ 49 | 25~ 34 | 12~ 24 | 10~ 11 | 6~ 9 | ≤5 | ||
Arterial pH | ≥7.70 | 7.60~ 7.69 | 7.50~ 7.59 | 7.33~ 7.49 | 7.25~ 7.32 | 7.15~ 7.24 | < 7.15 | ||
Oxygenation: A-aD02 orPa02 (mmHg) | |||||||||
a. FiO2 > 0.5 record A-aD02 | ≥500 | 350~ 499 | 200~ 349 | < 200 | |||||
b. Fi02 ≤ 0.5 record Pa02 | > 70 | 61~ 70 | 55~ 60 | < 55 | |||||
Serum sodium (mmol/L) | ≥180 | 160~ 179 | 155~ 159 | 150~ 154 | 130~ 149 | 120~ 129 | 111~ 119 | ≤110 | |
Serum potassium(mmol/L) | ≥7.0 | 6.0~ 6.9 | 5.5~ 5.9 | 3.5~ 5.4 | 3.0~ 3.4 | 2.5~ 2.9 | < 2.5 | ||
Serum creatinine) mg/dl) | ≥3.5 | 2.0~ 3.4 | 1.5~ 1.9 | 0.6~ 1.4 | < 0.6 | ||||
Hematocrit (%) | ≥60 | 50~ 59.9 | 46~ 49.9 | 30~ 45.9 | 20~ 29.9 | < 20 | |||
White blood cell count (× 1000) | ≥40 | 20~ 39.9 | 15~ 19.9 | 3~ 14.9 | 1~ 2.9 | < 1 | |||
Glasgow Coma Score | |||||||||
Eye Opening | verbal (Non-intubated) | veabal (intubated) | Motor Activity | ||||||
4-Spontaneous | 5-Oriented and talks | 5-Seemsable to talk | 6-Verbal command | ||||||
3-Verbal stimuli | 4-Disoricnted and talks | 3-Questionableabilhy to talk | 5-Localizedto pain | ||||||
2-Painful stimuli | 3-Inappropriate words | 1-Generally unresponsive | 4-Withdraws from pain | ||||||
1-No response | 2-Incomprehensihle sounds | 3-Decorticate | |||||||
1-No response | 2-Decerebrate | ||||||||
1-No response | |||||||||
Points Assigned to Age and Chronic Disease | |||||||||
Age, Years | Score | ||||||||
< 45 | 0 | ||||||||
45~ 54 | 2 | ||||||||
55~ 64 | 3 | ||||||||
65~ 74 | 5 | ||||||||
≥75 | 6 | ||||||||
Chronic Health (History of Chronic Conditions) | Score | ||||||||
None | 0 | ||||||||
if the patient is admitted after elective surgery | 2 | ||||||||
if the patient is admitted after emergency surgery or for a reason other than after elective surgery | 5 | ||||||||