Estimation of Physiologic Ability and Surgical Stress scoring system for predicting complications following abdominal surgery: A metaanalysis spanning 2004 to 2022

BACKGROUND Postoperative complications remain a paramount concern for surgeons and healthcare practitioners.AIM To present a comprehensive analysis of the Estimation of Physiologic Ability and Surgical Stress(E-PASS)scoring system’s efficacy in predicting postoperative complications following abdominal surgery.METHODS A systematic search of published studies was conducted,yielding 17 studies with pertinent data.Parameters such as preoperative risk score(PRS),surgical stress score(SSS),comprehensive risk score(CRS),postoperative complications,post-operative mortality,and other clinical data were collected for meta-analysis.Forest plots were employed for continuous and binary variables,withχ2 tests assessing heterogeneity(P value).RESULTS Patients experiencing complications after abdominal surgery exhibited significantly higher E-PASS scores compared to those without complications[mean difference and 95%confidence interval(CI)of PRS:0.10(0.05-0.15);SSS:0.04(0.001-0.08);CRS:0.19(0.07-0.31)].Following the exclusion of low-quality studies,results remained valid with no discernible heterogeneity.Subgroup analysis indicated that variations in sample size and age may contribute to hetero-geneity in CRS analysis.Binary variable meta-analysis demonstrated a correlation between high CRS and increased postoperative complication rates[odds ratio(OR)(95%CI):3.01(1.83-4.95)],with a significant association observed between high CRS and postoperative mortality[OR(95%CI):15.49(3.75-64.01)].CONCLUSION In summary,postoperative complications in abdominal surgery,as assessed by the E-PASS scoring system,are consistently linked to elevated PRS,SSS,and CRS scores.High CRS scores emerge as risk factors for heightened morbidity and mortality.This study establishes the accuracy of the E-PASS scoring system in predicting postoperative morbidity and mortality in abdominal surgery,underscoring its potential for widespread adoption in effective risk assessment.

Study on the Clinical and Endocrine Characteristics of Polycystic Ovary Syndrome with Different Ovarian Morphology

Objective To evaluate the differences of the clinical manifestation and endocrine situation in patients with different ovarian morphology of polycystic ovary syndrome （PCOS）. Methods A total of 234 PCOS patients were enrolled according to the ovary morphology and divided into three groups： 112 patients with B-polycystic ovary mor- phology （both two ovaries were PCOM, B-PCOM）, 50 with U-PCOM （only one ovary was PCOM） and 72 with N-PCOM （none was PCOM）. There were 39 infertile women without PCOS as control group. Data were analyzed by using SPSS 15.0 software. ResuIts There was no statistical difference in body mass index （BM1） among the three groups of PCOS. The endometrial thickness increased in patients with B-PCOM and decreased with N-PCOM. The levels of testosterone, androstenedione and luteinizing hormone increased in PCOS groups, especially in N-PCOM patients. HOMA-IR increased, HOMA-fl, disposition index （DI） and △160/AG60 decreased in patients with N- PCOM compared with in B-PCOM and U-PCOM groups. Higher level of total choles- terol （TC） and lower level of high-density lipoprotein （HDL）-C existed in PCOS patients, especially in N-PCOM. There were positive correlations between oligo-anovulation, endometrial thickness, LH/FSH ratio, fasting insulin （FINS）, the area under curve of glucose（A UCcLu） and PCOM, while there was a negative correlation between HOMA- IR and PCOM. Conclusion There are relationships among hyperandrogenism, hyperinsulinemia, insulin resistance （IR） and ovary morphology in PCOS patients. PCOS patients with- out PCOM have more serious IR and hyperandrogenism.