Comparison of POSSUM and the Portsmouth predictor equation for predicting death following vascular surgery

Comparison of Surgical Risk Score, POSSUM and p-POSSUM in higher-risk surgical patients

“…POSSUM and p‐POSSUM have been validated for the prediction of postoperative mortality in a large number of studies6, 7, 14, 20, 22, 24–29. POSSUM generally overpredicts mortality, as in this study, particularly in lower‐risk groups.…”

“…If a comparison of quality of care between individual surgeons or surgical units is to be valid, outcome measures must be standardized and the effect of non‐surgical factors controlled19. The currently accepted measure of surgical outcome is 30‐day postoperative mortality14, 20–22. The disadvantage of using mortality as an endpoint is that the majority of surgical procedures carry a low risk of death.…”

“…This characteristic is important if the SRS score is to be used as a scoring system in large groups of patients with a wide range of operative risk. Further evaluation of this characteristic is indicated for the higher‐risk categories, as has been done with POSSUM for specific procedures such as aortic and colorectal surgery20, 24, 25. One hundred and thirty patients analysed in this study had a mortality risk of 19 per cent or higher predicted by the SRS; this included 58 patients undergoing laparotomy for colonic pathology, 23 patients undergoing aortic procedures and 22 patients undergoing infrainguinal arterial bypass surgery.…”

The Evaluation of the Renal Transplant Candidates: Clinical Practice Guidelines

“…In a cohort of 7040 patients who died with a functioning graft after receiving a kidney transplant between 1988 and 1997, 36.1% of deaths were attributed to IHD and another 6.1% to stroke (620). Almost half (47.1%) of deaths with graft function occurring within 30 days after transplantation were due to CVD, primarily acute myocardial infarction (620 Other risk prediction algorithms for non-cardiac surgery include those of the American College of Cardiology and the American Heart Association (635), the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) (636,637), and the Portsmouth modification (P-POSSUM) (638)(639)(640)(641). Few studies have simultaneously compared several different risk prediction methods.…”