Igari Kimihiro, Ochiai Takanori, Yamazaki Shigeru
Hepatogastroenterology. 2013 Sep;60(126):1320-7. doi: 10.5754/hge13275.
BACKGROUND/AIMS: The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) and Portsmouth POSSUM (P-POSSUM) use preoperative and intraoperative factors to evaluate risk. We examined our surgical results to investigate predictive factors for morbidity and mortality, and evaluate the accuracy of the POSSUM and P-POSSUM.
Patients (n = 593) aged ≥80 years, undergoing general surgical procedures were enrolled. Logistic regression analysis was used to determine the independent predictors. The predicted outcomes using POSSUM and P-POSSUM were also compared with actual outcomes.
Physiological score (PS) and operative severity score (OS) were independent predictors of morbidity and mortality. Using POSSUM, the observed/expected (O/E) morbidity ratio was 1.44 and O/E mortality ratio was 0.98. Using P-POSSUM, the O/E mortality ratio was 1.0.
Even though POSSUM tended to underestimate the morbidity rate, POSSUM and P-POSSUM accurately predicted the mortality rate after general surgical procedures.
背景/目的：用于计算死亡率和发病率的生理与手术严重程度评分系统（POSSUM）以及朴茨茅斯POSSUM（P-POSSUM）利用术前和术中因素来评估风险。我们检查了我们的手术结果，以研究发病和死亡的预测因素，并评估POSSUM和P-POSSUM的准确性。
纳入年龄≥80岁、接受普通外科手术的患者（n = 593）。采用逻辑回归分析确定独立预测因素。还将使用POSSUM和P-POSSUM预测的结果与实际结果进行了比较。
生理评分（PS）和手术严重程度评分（OS）是发病和死亡的独立预测因素。使用POSSUM时，观察到的/预期的（O/E）发病率比值为1.44，O/E死亡率比值为0.98。使用P-POSSUM时，O/E死亡率比值为1.0。
尽管POSSUM往往低估发病率，但POSSUM和P-POSSUM准确预测了普通外科手术后的死亡率。
