Efficacy Safety Score in Postoperative Patients With and Without Comorbidities: A Prospective Comparative Study
Abstract
Postoperative complications contribute significantly to global morbidity and mortality, occurring in approximately 3-25% of surgical patients. The Efficacy Safety Score (ESS) is a multidimensional postoperative assessment tool designed to support early identification of complications. However, limited evidence exists on how comorbidities, types of anesthesia, and categories of surgery affect ESS outcomes. The purpose of the study was to compare postoperative ESS between patients with and without comorbidities, anesthesia, and surgery types. A prospective comparative cohort study was conducted using consecutive sampling among 153 postoperative patients in two hospitals. Demographic, clinical characteristics, and ESS were collected within 24 hours post-surgery. Statistical analyses included independent t-tests and one-way ANOVA, reporting mean differences, 95% confidence intervals (CIs), and effect sizes. The results showed patients with comorbidities had significantly higher ESS scores than those without (mean difference = 1.50, 95% CI: 0.68–2.32, Cohen’s d = 0.60, p < 0.001). General anesthesia was associated with higher ESS scores than regional anesthesia (mean difference = 0.96, 95% CI: 0.08–1.84, Cohen’s d = 0.38, p = 0.032). ESS differed significantly across surgery types, with orthopedic procedures yielding the highest scores (η² = 0.05, p = 0.018). These findings indicate that the presence of comorbidity, anesthesia type, and surgical category significantly influence postoperative ESS. The ESS findings may be useful for postoperative risk stratification; however, further validation studies are required before routine clinical implementation.
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