TITLE:
Risk Assessments for Elderly Patients with Hip Arthro-plasty Using POSSUM and P-POSSUM
AUTHORS:
Yuancheng Li, Hassan H. Dib, Weiguo Zhang, Xiao Zhang
KEYWORDS:
Hip Arthroplasty; Mortality; Morbidity; P-POSSUM; POSSUM
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.3 No.2,
May
31,
2013
ABSTRACT: Background:
The physiological and operative
severity score for the enumeration of mortality and morbidity (POSSUM) is a
scoring system previously validated in vascular and general surgical patients.
The Portsmouth physiological and operative severity score for the enumeration
of mortality and morbidity (P-POSSUM) is a reliable tool derived from POSSUM to
improve the prediction of mortality. In this paper, we utilized both models to determine the most suitable
and feasible one that could be utilized in orthopedic surgery in China
mainland. Methods: In
this retrospective study, patients’ files were extracted
randomly from the medical records department of the First
Hospital Affiliated with Dalian Medical University for those underwent hip replacements between 1999 and 2006. The mortality and morbidity rates were predicted by P-POSSUM and POSSUM, respectively.
A comparative analysis was performed between the observed and the predicted values as well as the
Observed/Expected ratio (O:E). Results:
A total of 206 patients were selected
for this study after fulfilling the inclusion and exclusion criteria. The
predicted mortality by P-POSSUM were not significantly different from the
observed values (X2 = 2.10,
P = 0.552).
POSSUM appeared to be better with the observed morbidity (X2 = 2.766,
P = 0.598),
but had overestimated mortality. Conclusion: The POSSUM morbidity
equation satisfactorily estimated
the risk of postoperative complications, and the P-POSSUM mortality equation appeared
to stratify the risk of death more accurate than the POSSUM.