Key result
The POSSUM scoring system significantly overpredicted 30-day postoperative morbidity in orthopedic surgery patients, predicting a 27.2% complication rate compared to the actual observed rate of 8.3%.
Why the study?
Does the POSSUM scoring system accurately predict postoperative morbidity in patients undergoing orthopedic surgery?
Observational (n=779)
No
Does the POSSUM scoring system accurately predict postoperative morbidity in patients undergoing orthopedic surgery?
Absolute Event Rate: 27.2% vs 8.3%
p-value: p=<0.001
The POSSUM scoring system overpredicts morbidity in orthopedic surgery patients, but its accuracy can be significantly improved by incorporating echocardiographic ejection fraction.
POSSUM overprediction warrants cautious use for orthopedic risk assessment; leaves open need for specialty-specific validation.
PURPOSE: Physical and operative severity score for the enumeration of mortality and morbidity (POSSUM) scoring system was designed to predict the postoperative morbidity and mortality mainly in general surgery. The purpose of this study was to assess the value of POSSUM scoring system in predicting outcomes of patients undergoing orthopedic surgery, and to do some modifications to make the system more accurate in predicting postoperative complication rates. METHODS: This is a retrospective clinical study involving 779 patients between April 1, 2009 and September 1, 2010. The postoperative complication rates were predicted by POSSUM, and then compared with the actual morbidity. Logistic regression was taken to improve the POSSUM equation. RESULTS: In the 779 cases, the predicted morbidity was 27.2% (212 cases) by POSSUM, while the actual morbidity is 8.3% (65 cases). CONCLUSION: POSSUM excessively predicted the morbidity of patients undergoing orthopedic surgery, and it could be more accurate with appropriate modification. Of all risk factors, echocardiography ejection fraction showed a close relationship with postoperative complications.
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Bao et al. (2015) conducted an observational in Orthopedic surgery (n=779). POSSUM scoring system vs. Actual observed morbidity was evaluated on Postoperative morbidity within 30 days (p=<0.001). The POSSUM scoring system significantly overpredicted 30-day postoperative morbidity in orthopedic surgery patients, predicting a 27.2% complication rate compared to the actual observed rate of 8.3%.
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