Application of POSSUM and P-POSSUM in Surgical Risk Assessment of Elderly Patients Undergoing Hepatobiliary and Pancreatic Surgery

Zhi-Wei Hu, Rui-Qiang Xin, Yi-Jun Xia, Guang-Peng Jia, Xiao-Xu Chen, Shi Wang Department of Hepatobiliary and Pancreatic Surgery, Inner Mongolia People’s Hospital, Hohhot, Inner Mongolia Autonomous Region, People’s Republic of ChinaCorrespondence: Shi WangDepartment of Hepatobili...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Hu ZW, Xin RQ, Xia YJ, Jia GP, Chen XX, Wang S
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	possum p-possum elderly patients postoperative complication rate mortalityrate Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/3c0956997e314d35b4c4f0267c7fef01
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:3c0956997e314d35b4c4f0267c7fef01
record_format	dspace
spelling	oai:doaj.org-article:3c0956997e314d35b4c4f0267c7fef012021-12-02T09:21:24ZApplication of POSSUM and P-POSSUM in Surgical Risk Assessment of Elderly Patients Undergoing Hepatobiliary and Pancreatic Surgery1178-1998https://doaj.org/article/3c0956997e314d35b4c4f0267c7fef012020-07-01T00:00:00Zhttps://www.dovepress.com/application-of-possum-and-p-possum-in-surgical-risk-assessment-of-elde-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Zhi-Wei Hu, Rui-Qiang Xin, Yi-Jun Xia, Guang-Peng Jia, Xiao-Xu Chen, Shi Wang Department of Hepatobiliary and Pancreatic Surgery, Inner Mongolia People’s Hospital, Hohhot, Inner Mongolia Autonomous Region, People’s Republic of ChinaCorrespondence: Shi WangDepartment of Hepatobiliary and Pancreatic Surgery, Inner Mongolia People’s Hospital, No. 20 Zhaowuda Road, Hohhot, Inner Mongolia Autonomous Region, People’s Republic of ChinaTel +86 18047192834Fax +86 4713283753Email 18047192834@163.comPurpose: 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 Methods: 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 t-tests, consistency of predicted and actual complication rates (observed/expected, OE ratio), and receiver operating characteristic (ROC) curve.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.Keywords: POSSUM, P-POSSUM, elderly patients, postoperative complication rate, mortality rateHu ZWXin RQXia YJJia GPChen XXWang SDove Medical Pressarticlepossump-possumelderly patientspostoperative complication ratemortalityrateGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 15, Pp 1121-1128 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	possum p-possum elderly patients postoperative complication rate mortalityrate Geriatrics RC952-954.6
spellingShingle	possum p-possum elderly patients postoperative complication rate mortalityrate Geriatrics RC952-954.6 Hu ZW Xin RQ Xia YJ Jia GP Chen XX Wang S Application of POSSUM and P-POSSUM in Surgical Risk Assessment of Elderly Patients Undergoing Hepatobiliary and Pancreatic Surgery
description	Zhi-Wei Hu, Rui-Qiang Xin, Yi-Jun Xia, Guang-Peng Jia, Xiao-Xu Chen, Shi Wang Department of Hepatobiliary and Pancreatic Surgery, Inner Mongolia People’s Hospital, Hohhot, Inner Mongolia Autonomous Region, People’s Republic of ChinaCorrespondence: Shi WangDepartment of Hepatobiliary and Pancreatic Surgery, Inner Mongolia People’s Hospital, No. 20 Zhaowuda Road, Hohhot, Inner Mongolia Autonomous Region, People’s Republic of ChinaTel +86 18047192834Fax +86 4713283753Email 18047192834@163.comPurpose: 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 Methods: 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 t-tests, consistency of predicted and actual complication rates (observed/expected, OE ratio), and receiver operating characteristic (ROC) curve.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.Keywords: POSSUM, P-POSSUM, elderly patients, postoperative complication rate, mortality rate
format	article
author	Hu ZW Xin RQ Xia YJ Jia GP Chen XX Wang S
author_facet	Hu ZW Xin RQ Xia YJ Jia GP Chen XX Wang S
author_sort	Hu ZW
title	Application of POSSUM and P-POSSUM in Surgical Risk Assessment of Elderly Patients Undergoing Hepatobiliary and Pancreatic Surgery
title_short	Application of POSSUM and P-POSSUM in Surgical Risk Assessment of Elderly Patients Undergoing Hepatobiliary and Pancreatic Surgery
title_full	Application of POSSUM and P-POSSUM in Surgical Risk Assessment of Elderly Patients Undergoing Hepatobiliary and Pancreatic Surgery
title_fullStr	Application of POSSUM and P-POSSUM in Surgical Risk Assessment of Elderly Patients Undergoing Hepatobiliary and Pancreatic Surgery
title_full_unstemmed	Application of POSSUM and P-POSSUM in Surgical Risk Assessment of Elderly Patients Undergoing Hepatobiliary and Pancreatic Surgery
title_sort	application of possum and p-possum in surgical risk assessment of elderly patients undergoing hepatobiliary and pancreatic surgery
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/3c0956997e314d35b4c4f0267c7fef01
work_keys_str_mv	AT huzw applicationofpossumandppossuminsurgicalriskassessmentofelderlypatientsundergoinghepatobiliaryandpancreaticsurgery AT xinrq applicationofpossumandppossuminsurgicalriskassessmentofelderlypatientsundergoinghepatobiliaryandpancreaticsurgery AT xiayj applicationofpossumandppossuminsurgicalriskassessmentofelderlypatientsundergoinghepatobiliaryandpancreaticsurgery AT jiagp applicationofpossumandppossuminsurgicalriskassessmentofelderlypatientsundergoinghepatobiliaryandpancreaticsurgery AT chenxx applicationofpossumandppossuminsurgicalriskassessmentofelderlypatientsundergoinghepatobiliaryandpancreaticsurgery AT wangs applicationofpossumandppossuminsurgicalriskassessmentofelderlypatientsundergoinghepatobiliaryandpancreaticsurgery
_version_	1718398114689187840

Application of POSSUM and P-POSSUM in Surgical Risk Assessment of Elderly Patients Undergoing Hepatobiliary and Pancreatic Surgery

Ejemplares similares