Yii Ming Kon
Department of Surgery, Sarawak General Hospital, Kuching, Sarawak, Malaysia.
Asian J Surg. 2003 Jul;26(3):149-53. doi: 10.1016/S1015-9584(09)60374-2.
Abdominal aortic aneurysm (AAA) repairs represent a significant workload in vascular surgery in Asia. This study aimed to audit AAA surgery and evaluate the application of the Portsmouth Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (P-POSSUM) in an Asian vascular unit for standard of care. Eighty-five consecutive surgical patients with AAA from a prospective vascular database from July 1996 to December 2001 in Sarawak were available for analysis. Comparisons between predicted deaths by P-POSSUM and observed deaths in both urgency of surgery categories (elective, urgent, emergency ruptures) and risk range groups (0-5%, >5-15%, >15-50%, >50-100%) were made. No significant difference was found between the predicted and observed rates of death for elective, urgent and emergency AAA repairs. The observed mortality rates were 5%, 18% and 30%, respectively. The observed rates of death were also comparable to P-POSSUM predicted rates of death in the various risk range groups. The POSSUM score used with the P-POSSUM mortality equation is easy to use and applicable as a comparative vascular auditing tool in Asia.
腹主动脉瘤（AAA）修复手术是亚洲血管外科的一项重要工作内容。本研究旨在审核AAA手术，并评估朴茨茅斯生理和手术严重程度评分系统（P-POSSUM）在亚洲一个血管科室作为护理标准的应用情况。对1996年7月至2001年12月在砂拉越的前瞻性血管数据库中连续85例接受AAA手术的患者进行分析。比较了P-POSSUM预测的死亡人数与不同手术紧急程度类别（择期、紧急、急诊破裂）和风险范围组（0-5%、>5-15%、>15-50%、>50-100%）中的实际死亡人数。择期、紧急和急诊AAA修复手术的预测死亡率与实际死亡率之间未发现显著差异。实际死亡率分别为5%、18%和30%。在不同风险范围组中，实际死亡率也与P-POSSUM预测的死亡率相当。与P-POSSUM死亡率方程一起使用的POSSUM评分易于使用，可作为亚洲血管外科的一种比较审核工具。
