A Systematic Review of POSSUM and its Related Models as Predictors of Post-operative Mortality and Morbidity in Patients Undergoing Surgery for Colorectal Cancer

Richards, Colin H.; Leitch, Fiona; Horgan, Paul G.; McMillan, Donald C.

doi:10.1007/s11605-010-1333-5

Cited by 72 publications

(41 citation statements)

References 57 publications

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“…In addition, it is possible that differences in timing for collection of physiological variables and laboratory values in relation to the operation may have influenced results. Our results for hip fracture patients contrast to the good discrimination by the POSSUM score in other patient groups and suggest that parameters other than those included in the score are of importance in these elderly and fragile patients 29, 30…”

Section: Discussioncontrasting

confidence: 67%

Accuracy of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity score and the Nottingham risk score in hip fracture patients in Sweden — A prospective observational study

Jonsson

Bentzer

Turkiewicz

et al. 2018

Acta Anaesthesiol Scand

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BackgroundLittle is known about accuracy of common risk prediction scores in elderly patients suffering from hip fractures. The objective of this study was to investigate accuracy of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) score, Portsmouth‐POSSUM (P‐POSSUM) score and the Nottingham Hip Fracture Score (NHFS) for prediction of mortality and morbidity in this patient group.MethodsThis was a prospective single centre observational study on 997 patients suffering out‐of‐hospital cervical, trochanteric or subtrochanteric fracture of the neck of the femur. Calibration and discrimination was assessed by calculating the ratio of observed to expected events (O:E) and areas under receiver operating characteristics curves (ROC).ResultsThe 30‐day mortality was 6.2% and complications, as defined by POSSUM, occurred in 41% of the patients. Overall O:E ratios for POSSUM, P‐POSSUM and NHFS scores for 30‐day mortality were 0.90, 0.98, and 0.79 respectively. The models underestimated mortality in the lower risk bands and overestimated mortality in the higher risk bands. In contrast, POSSUM predicted morbidity well with O:E ratios close to unity in most risk bands. The areas under the ROC curves for the scoring systems was 0.60‐0.67.ConclusionThe POSSUM score and NHFS show moderate calibration and poor discrimination in this cohort. The results suggest that mortality and morbidity in hip fracture patients are largely dependent on factors that are not included in these scores.

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Section: Discussioncontrasting

confidence: 67%

Accuracy of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity score and the Nottingham risk score in hip fracture patients in Sweden — A prospective observational study

Jonsson

Bentzer

Turkiewicz

et al. 2018

Acta Anaesthesiol Scand

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“…While there is increasing evidence that preoperative risk assessment is valid for various types of surgery [35,36] , data on esophageal cancer are somewhat inconclusive so far. For example, the most commonly used preoperative risk classification is the ASA classification [14] .…”

Section: Discussionmentioning

confidence: 99%

“…Most studies investigate the potential of risk scores to predict outcome by looking at classical end points such as mortality, morbidity or specific complications [35,36] . We could now demonstrate for the Altogether, our data implicate that esophageal cancerspecific preoperative risk scores might be a valid tool to improve the outcome of these patients by either careful patients selecting for surgery, or by preparing patients with relevant comorbidities before surgery by, for example, intensified pulmonary training [7,39] .…”

Section: Discussionmentioning

confidence: 99%

Esophageal Cancer Specific Risk Score Is Associated with Postoperative Complications Following Open Ivor-Lewis Esophagectomy for Adenocarcinoma

Lindner

Palmes²,

Grübener³

et al. 2015

Dig Surg

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Background/Aims: Surgery for esophageal cancer is associated with a high morbidity and mortality. With this study, we investigated if a validated preoperative risk score correlates with overall morbidity, mortality, anastomotic insufficiency, respiratory complications and with the severity of complications after open Ivor-Lewis esophagectomy. Methods: A total of 94 patients undergoing esophageal resection for adenocarcinoma between 2005 and 2009 were included. Patients were assigned using the preoperative risk score according to Schröder et al. [Langenbecks Arch Surg 2006;391:455-460] and the Dindo classification regarding the severity of complications. Results: Of all the patients, 12% had a ‘normal', 54% a ‘moderateʼ and 34% a ‘high' preoperative risk score. Postoperative complications occurred in 79%. Furthermore, 36 or 21 or 14 or 7% of patients experienced complications of category I/II or III or IV or V, respectively. There was a significant association between preoperative risk score and overall morbidity (p = 0.010), mortality (p = 0.035) and anastomotic insufficiency (p = 0.023). Furthermore, higher preoperative risk score was significant related to increasing severity of postoperative complications (grade IV according to the Dindo classification: p = 0.018, Dindo grade V: p = 0.035). Neoadjuvant therapy consisting of cisplatin and 5-fluorouracil had no influence. Conclusion: As we demonstrated, a significant association between preoperative risk score and occurrence and severity of postoperative complications after open Ivor-Lewis esophagectomy, standardized, organ-specific pre- and postoperative categorizations might be useful for individual clinical decision making in this group of patients.

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“…This P-POSSUM algorithm is designed primarily to assess risk of perioperative mortality rather than for complications or morbidity. 44 Since the development of the P-POSSUM algorithm, several specialty-specifi c models have been developed, with the oesophagogastric model (O-POS-SUM) designed for gastric and esophageal surgery. Tekkis et al 45 developed the O-POSSUM algorithm to focus primarily on these surgical outcomes.…”

Section: Predictive Modelingmentioning

confidence: 99%

The Impact of Age on Morbidity and Mortality following Esophagectomy for Esophageal Cancer

2013

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A Systematic Review of POSSUM and its Related Models as Predictors of Post-operative Mortality and Morbidity in Patients Undergoing Surgery for Colorectal Cancer

Abstract: P-POSSUM was the most accurate model for predicting post-operative mortality after colorectal cancer surgery. The original POSSUM model was accurate in predicting post-operative complications.

Cited by 72 publications

References 57 publications

Accuracy of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity score and the Nottingham risk score in hip fracture patients in Sweden — A prospective observational study

Accuracy of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity score and the Nottingham risk score in hip fracture patients in Sweden — A prospective observational study

Esophageal Cancer Specific Risk Score Is Associated with Postoperative Complications Following Open Ivor-Lewis Esophagectomy for Adenocarcinoma

The Impact of Age on Morbidity and Mortality following Esophagectomy for Esophageal Cancer

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