Key result
Possum scoring predicts postoperative morbidity but not mortality in head and neck surgery.
Why the study?
The validity of Possum and P-Possum scoring systems for predicting morbidity and mortality in head and neck surgery was uncertain.
Is the Possum scoring system applicable for predicting morbidity and mortality in head and neck surgery?
Observational (n=301)
Is the Possum scoring system applicable for predicting morbidity and mortality in head and neck surgery?
Possum scoring is valid for predicting morbidity in high-risk head and neck surgery patients, but new variables like prior radiotherapy and surgery should be included for better accuracy.
POSSUM and P-POSSUM may not reliably predict head and neck outcomes; leaves open need for validated specialty-specific models incorporating radiotherapy and prior surgery.
Possum (the physiological and operative severity score for the enumeration of mortality) is used in many surgical specialities for comparative audit. We investigated its validity in relation to head and neck surgery by retrospectively scoring 301 operative interventions. We also applied the P-Possum (Portsmouth Possum) equation for mortality. We compared our observed with the predicted outcomes. We introduced two new variables, radiotherapy and previous surgery to the operative site, to test their association with outcome. We found that Possum is valid for morbidity but predicts more accurately for high-risk than for low-risk groups. Neither Possum or P-Possum accurately predicts mortality. Radiotherapy and previous surgery were both significant for the development of postoperative complications (P = 0.002, P = 0.007 respectively) and are worthy of inclusion in a Possum score for head and neck surgery.
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Griffiths et al. (2002) conducted an observational in Head and neck surgery (n=301). Possum and P-Possum scoring systems was evaluated on Morbidity and mortality. Possum scoring validly predicted morbidity but not mortality in head and neck surgery, while radiotherapy and previous surgery significantly predicted postoperative complications (P=0.002 and P=0.007).
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