Jones H J, de Cossart L
Countess of Chester Hospital, Chester, UK.
Br J Surg. 1999 Feb;86(2):149-57. doi: 10.1046/j.1365-2168.1999.01006.x.
A large number of scoring systems for assessing a patient's risk of complications or death has been developed over recent years. This is a review of those that are of relevance to general surgeons.
A Medline literature search was performed to identify all articles concerning 'severity of illness', 'morbidity', 'mortality' and 'postoperative complications' in the field of surgery from 1966 to 1997. Further searches were performed to find papers about specific identified scoring systems, and relevant articles from the reference lists of these were also sought.
The advantages of an accurate assessment of a patient's risk include, on an individual level, the opportunity to give a more accurate prognosis and choose the most appropriate treatment. If the risk of an adverse outcome is known for a group of patients, the actual outcome can be compared with the predicted outcome, and comparison can be made between groups in different surgical units for the purposes of audit or research. The Physiological and Operative Severity Score for enUmeration of Mortality and morbidity (POSSUM) is the most appropriate of the currently available scores for general surgical practice.
近年来已开发出大量用于评估患者并发症或死亡风险的评分系统。本文对普通外科医生相关的评分系统进行综述。
进行了Medline文献检索，以识别1966年至1997年外科领域中所有关于“疾病严重程度”“发病率”“死亡率”和“术后并发症”的文章。进一步检索以查找有关特定已识别评分系统的论文，并从这些论文的参考文献列表中寻找相关文章。
准确评估患者风险的优势包括，在个体层面上，有机会给出更准确的预后并选择最合适的治疗方法。如果已知一组患者出现不良结局的风险，实际结局可与预测结局进行比较，并且出于审核或研究目的，可在不同外科单位的组间进行比较。用于计算死亡率和发病率的生理和手术严重程度评分（POSSUM）是目前普通外科实践中最合适的可用评分。
