Key result
POSSUM accurately predicts 30-day postoperative complications, while P-POSSUM accurately predicts surgical mortality.
Why the study?
To investigate the efficacy and accuracy of POSSUM and P-POSSUM scoring systems in assessing postoperative complications and death in elderly patients undergoing hepatobiliary and pancreatic surgery.
Do POSSUM and P-POSSUM scoring systems accurately predict postoperative complications and mortality in elderly patients undergoing hepatobiliary and pancreatic surgery?
Observational (n=274)
No
Do POSSUM and P-POSSUM scoring systems accurately predict postoperative complications and mortality in elderly patients undergoing hepatobiliary and pancreatic surgery?
POSSUM accurately predicts postoperative complications, while P-POSSUM accurately predicts mortality in elderly patients undergoing hepatobiliary and pancreatic surgery.
Answers are grounded in this paper and cite their sources.
May aid preoperative risk stratification in elderly HPB surgery patients; leaves open prospective validation before routine adoption.
PURPOSE: 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. PATIENTS AND RESULTS: 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. CONCLUSION: 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.
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Xin et al. (2020) conducted an observational in Hepatobiliary and pancreatic diseases requiring surgical treatment (n=274). POSSUM and P-POSSUM surgical risk scoring systems vs. Actual observed 30-day postoperative complication and mortality rates was evaluated on 30-day postoperative complication rate (POSSUM predicted vs actual observed) (p=0.1670). POSSUM accurately predicted 30-day postoperative complications, while P-POSSUM accurately predicted mortality.
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