用于评估急诊手术老年患者死亡率和发病率的生理与手术严重程度评分以及改良的用于评估急诊手术老年患者死亡率和发病率的生理与手术严重程度评分，用于死亡率预测。

Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity and modified Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity for the mortality prediction among nonagenarians undergoing emergency surgery.

作者信息

Imaoka Yuki, Itamoto Toshiyuki, Nakahara Hideki, Oishi Koichi, Matsugu Yasuhiro, Urushihara Takashi

机构信息

Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, Minami-ku, Hiroshima, Japan; Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan.

出版信息

J Surg Res. 2017 Apr;210:198-203. doi: 10.1016/j.jss.2016.11.040. Epub 2016 Dec 3.

DOI:10.1016/j.jss.2016.11.040

PMID:28457329

Abstract

BACKGROUND

The aims of this study were to determine the outcomes of emergency abdominal surgery in patients aged ≥90 y and to analyze the role of Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) and modified POSSUM in predicting their morbidity and mortality.

MATERIALS AND METHODS

Patients aged ≥90 y who underwent emergency abdominal surgery from January 2011 to December 2014 were enrolled in this study.

RESULTS

A total of 36 patients satisfied the inclusion criteria. The mortality and morbidity rates in the study group were 8.3% and 61.1%, respectively. Overall observed-to-expected morbidity ratio calculated by POSSUM and modified POSSUM were 0.83 (χ = 32.189, P = 0.6045) and 0.97 (χ = 33.915, P = 0.7398), respectively. Both models demonstrated a good fit for prediction of morbidity. Overall observed-to-expected mortality ratios calculated by POSSUM and modified POSSUM were 0.26 (χ = 12.217, P = 0.2013) and 0.20 (χ = 12.217, P = 0.0936), respectively.

CONCLUSIONS

Both POSSUM and modified POSSUM accurately predicted morbidity in the setting of emergency abdominal surgery in nonagenarians.

摘要

背景

本研究旨在确定90岁及以上患者急诊腹部手术的结局，并分析生理和手术严重程度评分系统（POSSUM）及改良POSSUM在预测其发病率和死亡率方面的作用。

材料与方法

纳入2011年1月至2014年12月期间接受急诊腹部手术的90岁及以上患者。

结果

共有36例患者符合纳入标准。研究组的死亡率和发病率分别为8.3%和61.1%。通过POSSUM和改良POSSUM计算的总体观察到的与预期的发病率比值分别为0.83（χ=32.189，P=0.6045）和0.97（χ=33.915，P=0.7398）。两种模型对发病率的预测拟合度均良好。通过POSSUM和改良POSSUM计算的总体观察到的与预期的死亡率比值分别为0.26（χ=12.217，P=0.2013）和0.20（χ=12.217，P=0.0936）。