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Predictive Value of MAP and E-PASS Scores for Postoperative Complications following Laparoscopic Total and Partial
Ali Yasin Ozercan1, Serdar Basboga2, Kamal Karimzada3
1Department of Urology, Ministry of Health, Kayseri City Hospital, Kayseri, Turkey.
Introduction:
The aim of the study was to evaluate the predictive value of Mayo Adhesive Probability (MAP) and the Estimation of Physiologic Ability and Surgical Stress (E-PASS) scores for postoperative complications in laparoscopic total adrenalectomy (LTA) and partial adrenalectomy (LPA).
Methods:
This study included 140 patients who underwent transperitoneal laparoscopic adrenalectomy at our clinic. Patients were grouped based on the presence (group 1, n = 11) or absence (group 2, n = 129) of complications. Preoperative, perioperative, and postoperative data were collected. A MAP score ≥2 was defined as high.
Results:
Group 1 had a higher incidence of chronic pulmonary and coronary artery disease (p < 0.001). Operative time and estimated blood loss (EBL) were also significantly greater (p = 0.036 and p = 0.041). High MAP scores were more common in this group (p = 0.008), and E-PASS scores were significantly elevated. Univariate logistic regression analysis revealed predictive value for both MAP and Comprehensive Risk Score (CRS) (OR: 5.8, 95% CI: 1.6-21.1, p = 0.008; OR: 18.77, 95% CI: 4.75-74.3, p = 0.000, respectively) for complications. However, multivariate analysis identified only CRS and EBL as independent predictors (OR: 13.5, 95% CI: 2.26-80.6, p = 0.001 and OR: 1.007, 95% CI: 1.001-1.010, p = 0.013, respectively).
Conclusion:
The MAP and E-PASS scores are both useful for predicting postoperative complications in patients undergoing LTA and LPA. However, the E-PASS score was found to have independent predictive value for postoperative complications.
