An Overview of Risk Stratification in the Elderly Orthopaedic Population

Gentry, Ryan D.; Dineen, Hannah A.; Hahn, Jesse C.

doi:10.1007/s13670-017-0230-0

Cited by 6 publications

(4 citation statements)

References 57 publications

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“…The use of scores for predicting postoperative morbidity after orthopaedic surgery is not commonly employed yet, although it is developed in other surgical fields such as gastrointestinal and pulmonary surgery. 48 The Estimation of Physiologic Ability and Surgical Stress (E-PASS) is a score developed in the aforementioned surgical fields. E-PASS score is composed of a preoperative risk score (PRS) that considers patients’ comorbidities and performance status, like CGA; a Surgical Stress Score (SSS) that includes intraoperative factors as blood loss, surgical times and other.…”

Section: Discussionmentioning

confidence: 99%

The importance of geriatric and surgical co-management of elderly in muscoloskeletal oncology: A literature review

Vitiello¹,

Bellieni²,

Oliva³

et al. 2020

Orthop Rev (Pavia)

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People over 65 years old are the fastestgrowing part of the population and also the most common population in oncological practice. The geriatric co-assessment when involved in the management of orthopedic elderly patients could improve the survival and clinical outcomes of the patients. The aim of this review is to understand the importance of comprehensive geriatric assessment in elderly cancer orthopaedic patients affected by bone and soft tissue sarcoma in order to apply it and identify the mean surgical prognostic factors of this population.

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Section: Discussionmentioning

confidence: 99%

The importance of geriatric and surgical co-management of elderly in muscoloskeletal oncology: A literature review

Vitiello¹,

Bellieni²,

Oliva³

et al. 2020

Orthop Rev (Pavia)

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show abstract

“…In actual clinical work, active preoperative preparation will significantly reduce the adverse events of patients during the perioperative period. Surgical risk prediction models are a very valuable tool for surgeons because these tools allow surgeons to assess and prevent patients’ perioperative events in advance, so as to make the best decisions to optimize resources and improve the quality of care for patients [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Application of POSSUM and P-POSSUM scores in the risk assessment of elderly hip fracture surgery: systematic review and meta-analysis

Wang

Zhang

et al. 2022

J Orthop Surg Res

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Background Since Mohamed et al. analyzed 2326 orthopedic cases in 2002 and believed that the POSSUM formula can be directly used to predict postoperative morbidity and mortality in orthopedic patients, applications of POSSUM and P-POSSUM scores in the hip fracture surgery have been mostly reported in the field of orthopedics, but there are still some inconsistencies in the related reports. Methods The electronic library was searched for all literature that met the purpose from its inception to 2021. Relative risk (RR) was selected to evaluate whether the model could be used to assess the risk of surgery in patients with elderly hip fractures. Finally, sensitivity analyses and subgroup analyses were performed. Results Thirteen studies were finally included, including 9 retrospective and 4 prospective studies.The morbidity analysis includes 11 studies, and the result was RR = 1.07 (95% CI 0.93–1.24), The mortality analysis includes 11 studies on POSSUM and 5 studies on P-POSSUM. The results of mortality by POSSUM and by P-POSSUM were RR = 1.93 (95% CI 1.21–3.08) and RR = 1.15 (95% CI 0.89–1.50), respectively. POSSUM had more accuracy to predict mortality for sample < 200 subgroup(RR = 2.45; 95% CI 0.71–8.42) than sample > 200 subgroup(RR = 1.59; 95% CI 1.06–2.40), and in the subgroup of hip fractures that did not distinguish between specific fracture types(RR = 1.69, 95% CI 0.87–3.32) than intertrochanteric neck fracture subgroup(RR = 5.04, 95% CI 1.07–23.75) and femoral femoral fracture subgroup(RR = 1.43,95% CI 1.10–1.84). Conclusion POSSUM can be used to predict morbidity in elderly hip fractures. The P-POSSUM was more accurate in predicting mortality in elderly hip fracture patients compared to the POSSUM, whose predictive value for mortality was influenced by the sample size and type of fracture studied. In addition, we believe that appropriate improvements to the POSSUM system are needed to address the characteristics of orthopedic surgery.

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“…Surgical risk prediction models are a very valuable tool for surgeons, because these tools allow surgeons to assess and prevent patients' perioperative events in advance, so as to make the best decisions to optimize resources and improve the quality of care for patients. [7,8].…”

Section: Introductionmentioning

confidence: 99%

Application of POSSUM and P-POSSUM Scores in the Risk Assessment of Elderly Hip Fracture Surgery: Systematic Review and Meta-analysis

Feng

Zhang

et al. 2022

Preprint

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Background: Since Mohamed et al analyzed 2326 orthopedic cases in 2002 and believed that the POSSUM formula can be directly used to predict postoperative morbidity and mortality in orthopedic patients, applications of POSSUM and P-POSSUM scores in the hip fracture surgery have been mostly reported in the field of orthopedics, but there are still some inconsistencies in the related reports. Methods: The electronic library was searched for all literature that met the purpose from its inception to 2021. Relative risk (RR) was selected to evaluate whether the model could be used to assess the risk of surgery in patients with elderly hip fractures. Finally, sensitivity analyses and subgroup analyses were performed.Results: Thirteen studies were finally included, including 9 retrospective and 4 prospective studies.The morbidity analysis includes 11 studies, and the result was RR=1.07 (95%CI: 0.93-1.24), The mortality analysis includes 11 studies on POSSUM and 5 studies on P-POSSUM. The results of mortality by POSSUM and by P-POSSUM were RR=1.93 (95%CI: 1.21-3.08) and RR=1.15 (95%CI: 0.89-1.50), respectively. POSSUM had more accuracy to predict mortality for sample<200 subgroup(RR=2.45; 95%CI: 0.71-8.42) than sample>200 subgroup (RR=1.59; 95%CI: 1.06-2.40), and in the subgroup of hip fractures that did not distinguish between specific fracture types(RR=1.69, 95%CI: 0.87-3.32) than intertrochanteric neck fracture subgroup(RR=5.04,95%CI: 1.07-23.75) and femoral femoral fracture subgroup(RR=1.43 ,95% CI: 1.10-1.84).Conclusion: POSSUM can be used to predict morbidity in elderly hip fractures. The P-POSSUM was more accurate in predicting mortality in elderly hip fracture patients compared to the POSSUM, whose predictive value for mortality was influenced by the sample size and type of fracture studied. In addition, we believe that appropriate improvements to the POSSUM system are needed to address the characteristics of orthopaedic surgery.

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An Overview of Risk Stratification in the Elderly Orthopaedic Population

Cited by 6 publications

References 57 publications

The importance of geriatric and surgical co-management of elderly in muscoloskeletal oncology: A literature review

The importance of geriatric and surgical co-management of elderly in muscoloskeletal oncology: A literature review

Application of POSSUM and P-POSSUM scores in the risk assessment of elderly hip fracture surgery: systematic review and meta-analysis

Application of POSSUM and P-POSSUM Scores in the Risk Assessment of Elderly Hip Fracture Surgery: Systematic Review and Meta-analysis

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