Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) system for outcome prediction in elderly patients submitted to hip fracture emergency surgery

2017 ◽  
Author(s):  
Ana Rita Teles
Keyword(s):  
Hip Fracture ◽  
Elderly Patients ◽  
Emergency Surgery ◽  
Severity Score ◽  
Outcome Prediction ◽  
Mortality And Morbidity ◽  
Operative Severity Score

scholarly journals Efficacy of Possum in Surgical Audit of Patient Undergoing Emergency Surgery at Nepalgunj Medical College

2018 ◽  
Vol 14 (2) ◽  
pp. 2-7
Author(s):  
S V Bharti ◽  
S M Mishra ◽  
R R Ranjitkar ◽  
A O Chhetri
Keyword(s):  
Risk Factors ◽  
Emergency Surgery ◽  
Severity Score ◽  
Scoring System ◽  
College Teaching ◽  
Treatment Modalities ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Operative Severity Score ◽  
Significant Difference

 Introduction: The Physiological and Operative Severity Score for the en Umeration of Mortality and morbidity (POSSUM) has been proposed as a method for standardizing patient data so that direct comparisons can be made in spite of differing patterns of referral and population.Aims and objectives: To evaluate the efficacy of a scoring system for predicting the incidence of postoperative complications and mortality in patient undergoing Emergency Surgeries based on the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM).Material and Methods: This is a hospital based cross sectional study of all the cases that had undergone Emergency Surgery at Nepalgunj Medical College Teaching Hospital from the period of July 2014 to June 2015. The period of follow up was 30 days following the surgical procedure? A total of 100 emergency surgeries, as defined by the POSSUM scoring system criteria were studied. Predicted mortality and morbidity rates were calculated using the POSSUM equation by exponential analysis method. It was then compared with the actual outcomes. Observed: Expected Ratio (O:E) was calculated and difference detected by chi-square test. The risk factors as scored in the POSSUM criteria were noted.Results: Applying exponential analysis, an observed to expected ratio (O:E) for mortality of 0.44 was obtained, indicating significant 2 difference between the predicted and observed values (x =93.207, df 63, p=0.008). But, an observed to expected ratio (O:E) for 2 morbidity of 1.01 was obtained and there was no significant difference between the predicted and observed values (x =76.295, df 71, p=0.312). It was found to be comparable to other studies. In all the risk factors studied, a positive correlation was found between deaths and post-operative complications with higher POSSUM scores.Conclusion: POSSUM scoring system could accurately predict overall morbidity while it over predicted the overall mortality. POSSUM scoring system serves as a good predictor of post-operative outcome in major general surgical procedures and was applicable even in our setup and be used for comparing various treatment modalities and assessing the quality of care provided. JNGMC Vol. 14 No. 2 December 2016,   page: 2-7  

scholarly journals POSSUM escore como preditor de mortalidade em pacientes cirúrgicos

2009 ◽  
Vol 43 (1) ◽  
pp. 23-29 ◽  
Author(s):  
Adriana Cristina Galbiatti Parminondi Elias ◽  
Tiemi Matsuo ◽  
Cíntia Magalhães Carvalho Grion ◽  
Lucienne Tibery Queiroz Cardoso ◽  
Paulo Henrique Verri
Keyword(s):  
Severity Score ◽  
Apache Ii ◽  
Mortality And Morbidity ◽  
Operative Severity Score

O estudo avaliou a utilização do escore POSSUM (Physiological and Operative Severity Score for Enumeration of Mortality and Morbidity) para predizer a mortalidade na prática cirúrgica.Foram analisados 416 pacientes cirúrgicos com internação na UTI para cuidados de pós-operatório. Foram realizadas comparações entre as taxas de mortalidade predita e observada de acordo com 4 grupos de risco: 0-4%, 5-14%, 15-49%, 50% ou mais, e calculada a área sob a curva ROC do escore POSSUM e APACHE II para a mortalidade. A taxa de mortalidade foi de 22,4%. O escores POSSUM e APACHE II superestimaram o risco de morte, e a área sob a curva ROC do POSSUM foi de 0,762 e a do APACHE II de 0,737, sugerindo a utilização do POSSUM como ferramenta auxiliar na predição de risco de morte em pacientes cirúrgicos.

scholarly journals Evaluation of Nottingham Hip Fracture Score, Age-Adjusted Charlson Comorbidity Index and the Physiological and Operative Severity Score for the enumeration of Mortality and morbidity as predictors of mortality in elderly neck of femur fracture patients

2020 ◽  
Vol 8 ◽  
pp. 205031212091826 ◽  
Author(s):  
Michael James Nelson ◽  
Justin Scott ◽  
Palvannan Sivalingam
Keyword(s):  
Hip Fracture ◽  
Charlson Comorbidity Index ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Mortality Prediction ◽  
Mortality And Morbidity ◽  
Operative Severity Score ◽  
Significant Difference ◽  
Comorbidity Index ◽  
Operating Characteristic Curve

Background: This study evaluated the use of several risk prediction models in estimating short- and long-term mortality following hip fracture in an Australian population. Methods: Data from 195 patients were retrospectively analysed and applied to three models of interest: the Nottingham Hip Fracture Score, the Age-Adjusted Charlson Comorbidity Index and the Physiological and Operative Severity Score for enUmeration of Mortality and Morbidity. The performance of these models was assessed with receiver operating characteristic curve as well as logistic regression modelling. Results: The median age of participants was 83 years and 69% were women. Ten percent of patients were deceased by 30 days, 25% at 6 months and 31% at 12 months post-operatively. While there was no statistically significant difference between the models, the Age-Adjusted Charlson Comorbidity Index had the largest area under the receiver operating characteristic curve for within 30 day and 12 month mortality, while the Nottingham Hip Fracture Score was largest for 6-month mortality. There was no evidence to suggest that the models were selecting a specific subgroup of our population, therefore, no indication was present to suggest that using multiple models would improve mortality prediction. Conclusions: While there was no statistically significant difference in mortality prediction, the Nottingham Hip Fracture Score is perhaps the best suited clinically, due to its ease of implementation. Larger prospective data collection across a variety of sites and its role in guiding clinical management remains an area of interest.

scholarly journals POSSUM and P-POSSUM Scoring in Hip Fracture Mortalities

2020 ◽  
Vol 11 ◽  
pp. 215145932093167
Author(s):  
William L. Johns ◽  
Benjamin Strong ◽  
Stephen Kates ◽  
Nirav K. Patel
Keyword(s):  
Hip Fracture ◽  
High Risk ◽  
Mortality Rate ◽  
Clinical Decision Making ◽  
Tertiary Care ◽  
Significant Risk ◽  
Screening Tools ◽  
Morbidity And Mortality ◽  
Mortality And Morbidity ◽  
Operative Severity Score

Introduction: Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) and Portsmouth POSSUM (P-POSSUM) are general surgical tools used to efficiently assess mortality and morbidity risk. Data suggest that these tools can be used in hip fracture patients to predict morbidity and mortality; however, it is unclear what score indicates a significant risk on a case-by-case basis. We examined the POSSUM and P-POSSUM scores in a group of hip fracture mortalities in order to assess their accuracy in identification of similar high-risk patients. Materials and Methods: Retrospective analysis of all consecutive mortalities in hip fracture patients at a single tertiary care center over 2 years was performed. Patient medical records were examined for baseline demographics, fracture characteristics, surgical interventions, and cause of death. Twelve physiological and 6 operative variables were used to retrospectively calculate POSSUM and P-POSSUM scores at the time of injury. Results: Forty-seven hip fracture mortalities were reviewed. Median patient age was 88 years (range: 56-99). Overall, 68.1% (32) underwent surgical intervention. Mean predicted POSSUM morbidity and mortality rates were 73.9% (28%-99%) and 31.1% (5%-83%), respectively. The mean predicted P-POSSUM mortality rate was 26.4% (1%-91%) and 53.2% (25) had a P-POSSUM predicted mortality of >20%. Subgroup analysis demonstrated poor agreement between predicted mortality and observed mortality rate for POSSUM in operative (χ2 = 127.5, P < .00001) and nonoperative cohorts (χ2 = 14.6, P < .00001), in addition to P-POSSUM operative (χ2 = 101.9, P < .00001) and nonoperative (χ2 = 11.9, P < .00001) scoring. Discussion/Conclusion: Hip fracture patients are at significant risk of both morbidity and mortality. A reliable, replicable, and accurate tool to represent the expected risk of such complications could help facilitate clinical decision-making to determine the optimal level of care. Screening tools such as POSSUM and P-POSSUM have limitations in accurately identifying high-risk hip fracture patients.

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