PURPOSE: POSSUM (Physiologic and Operative Severity Score for enUmeration of Morbidity & Mortality) and P-POSSUM have been validated as scoring tools for the prediction of postoperative complications in general surgical patients. More recently a colorectal-specific POSSUM has been developed for mortality prediction. This study was designed to evaluate and compare the accuracy for mortality prediction of POSSUM, P-POSSUM, and colorectal POSSUM after major and complex major colorectal procedures. METHODS: The relationship between the observed and expected morbidity and mortality was examined in 347 consecutive patients (321 elective, 26 urgent) undergoing a major or complex major colorectal resection using POSSUM, P-POSSUM, and Colorectal POSSUM. The accuracy of using these scoring tools to predict mortality was assessed using Receiver Operator Characteristic curve analysis. RESULTS: A total of 347 consecutive patients (median age, 69 (range, 34-92) years) were assessed. Seventy-one patients (20.5 percent) suffered a postoperative complication and 15 patients (4.3 percent) died. The observed: expected POSSUM ratio for morbidity was 0.71 and mortality 0.68. The area under curve from Receiver Operator Characteristic curve analysis for POSSUM was 0.752. The observed:expected mortality ratio for P-POSSUM was 0.71, and the area under curve from Receiver Operator Characteristic curve analysis was 0.749. The observed:expected mortality ratio for colorectal POSSUM was 0.75, and the area under the curve from Receiver Operator Characteristic curve analysis was 0.781. CONCLUSIONS: Colorectal POSSUM provides comparable prediction of mortality risk after colorectal resection compared with POSSUM and P-POSSUM.
PURPOSE: POSSUM (Physiologic and Operative Severity Score for enUmeration of Morbidity & Mortality) and P-POSSUM have been validated as scoring tools for the prediction of postoperative complications in general surgical patients. More recently a colorectal-specific POSSUM has been developed for mortality prediction. This study was designed to evaluate and compare the accuracy for mortality prediction of POSSUM, P-POSSUM, and colorectal POSSUM after major and complex major colorectal procedures. METHODS: The relationship between the observed and expected morbidity and mortality was examined in 347 consecutive patients (321 elective, 26 urgent) undergoing a major or complex major colorectal resection using POSSUM, P-POSSUM, and Colorectal POSSUM. The accuracy of using these scoring tools to predict mortality was assessed using Receiver Operator Characteristic curve analysis. RESULTS: A total of 347 consecutive patients (median age, 69 (range, 34-92) years) were assessed. Seventy-one patients (20.5 percent) suffered a postoperative complication and 15 patients (4.3 percent) died. The observed: expected POSSUM ratio for morbidity was 0.71 and mortality 0.68. The area under curve from Receiver Operator Characteristic curve analysis for POSSUM was 0.752. The observed:expected mortality ratio for P-POSSUM was 0.71, and the area under curve from Receiver Operator Characteristic curve analysis was 0.749. The observed:expected mortality ratio for colorectal POSSUM was 0.75, and the area under the curve from Receiver Operator Characteristic curve analysis was 0.781. CONCLUSIONS: Colorectal POSSUM provides comparable prediction of mortality risk after colorectal resection compared with POSSUM and P-POSSUM.
Authors: Marisa Baré; Manuel Jesús Alcantara; Maria José Gil; Pablo Collera; Marina Pont; Antonio Escobar; Cristina Sarasqueta; Maximino Redondo; Eduardo Briones; Paula Dujovne; Jose Maria Quintana Journal: BMC Health Serv Res Date: 2018-01-29 Impact factor: 2.655
Authors: Ivan Facile; Raffaele Galli; Alberto Posabella; Raoul André Droeser; Pavlo Dinter; Robert Rosenberg; Markus Von Flüe; Daniel Christian Steinemann Journal: Langenbecks Arch Surg Date: 2020-10-20 Impact factor: 3.445