Application of POSSUM and P-POSSUM in Surgical Risk Assessment of Elderly Patients Undergoing Hepatobiliary and Pancreatic Surgery.
P-POSSUM
POSSUM
elderly patients
mortality rate
postoperative complication rate
Journal
Clinical interventions in aging
ISSN: 1178-1998
Titre abrégé: Clin Interv Aging
Pays: New Zealand
ID NLM: 101273480
Informations de publication
Date de publication:
2020
2020
Historique:
received:
07
05
2020
accepted:
26
06
2020
entrez:
9
8
2020
pubmed:
9
8
2020
medline:
30
12
2020
Statut:
epublish
Résumé
To investigate the efficacy and accuracy of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) and Portsmouth-POSSUM (P-POSSUM) scoring systems in the risk assessment of postoperative complications and death in elderly patients undergoing hepatobiliary and pancreatic surgery. Using POSSUM and P-POSSUM, 274 elderly patients undergoing hepatobiliary and pancreatic surgery were evaluated, and the complications and deaths predicted by the systems were compared with the actual situation. The accuracy and predictive ability of POSSUM and P-POSSUM were evaluated using chi-squared and The complication rate predicted by POSSUM (R1) was 22.57%, while the actual postoperative complication rate was 17.88% (P>0.05). The mortality rate predicted by POSSUM (R2) was 4.61%, while the actual rate was 1.09% (P<0.05). The mortality rate predicted by P-POSSUM (R) was 1.42%, while the actual rate was 1.09% (P>0.05). Patients with complications had higher physiology scores (PS), operative severity scores (OS), and POSSUM scores than those without complications (P<0.05). Furthermore, PS, OS, and POSSUM scores were higher in the mortality group than in the survival group. However, the number of individuals in the mortality group was too small to accurately reflect the overall situation. Stratified analysis showed that consistency of the OE ratio in different subgroups was close to 1. The ROC curve showed that the area under the curve for the complication rate predicted by POSSUM was 0.76. Although the postoperative mortality rate was higher than the actual value, POSSUM could accurately predict the postoperative complication rate in elderly patients undergoing hepatobiliary and pancreatic surgery. The P-POSSUM accurately predicted the postoperative mortality rate in this population. Patients with complications had higher POSSUM scores.
Identifiants
pubmed: 32764899
doi: 10.2147/CIA.S258659
pii: 258659
pmc: PMC7367927
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1121-1128Informations de copyright
© 2020 Hu et al.
Déclaration de conflit d'intérêts
Zhiwei Hu and Ruiqiang Xin are co first authors. The authors report no conflicts of interest in this work.
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