CR-POSSUM and Surgical Apgar Score as predictive factors for patients’ allocation after colorectal surgery

Pinho, Sílvia; Lagarto, F.; Gomes, B.; Costa, Liliana; Nunes, Catarina S.; Oliveira, Carla de

doi:10.1016/j.bjane.2018.01.006

Cited by 6 publications

(3 citation statements)

References 25 publications

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“…Some evidence indicated that SAS, combined with other criteria, has a better diagnostic ability to estimate complications after surgeries. Pinho et al [ 50 ] examined Possum and SAS for their utility in determining whether to admit patients to the ICU right away following colorectal surgery; they found that Possum had greater sensitivity and specificity, but the drawback is that it needs a wide variety of clinical and laboratory data. In addition to the initial SAS, various iterations of the SAS were created by researchers to more accurately pinpoint the hazards related to particular patients or surgical groups.…”

Section: Discussionmentioning

confidence: 99%

Ability to predict surgical outcomes by surgical Apgar score: a systematic review

Mirzaiee,

Soleimani,

Banoueizadeh

et al. 2023

BMC Surg

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Background The Surgical Apgar score (SAS) is a straightforward and unbiased measure to assess the probability of experiencing complications after surgery. It is calculated upon completion of the surgical procedure and provides valuable predictive information. The SAS evaluates three specific factors during surgery: the estimated amount of blood loss (EBL), the lowest recorded mean arterial pressure (MAP), and the lowest heart rate (LHR) observed. Considering these factors, the SAS offers insights into the probability of encountering postoperative complications. Methods Three authors independently searched the Medline, PubMed, Web of Science, Scopus, and Embase databases until June 2022. This search was conducted without any language or timeframe restrictions, and it aimed to cover relevant literature on the subject. The inclusion criteria were the correlation between SAS and any modified/adjusted SAS (m SAS, (Modified SAS). eSAS, M eSAS, and SASA), and complications before, during, and after surgeries. Nevertheless, the study excluded letters to the editor, reviews, and case reports. Additionally, the researchers employed Begg and Egger's regression model to evaluate publication bias. Results In this systematic study, a total of 78 studies \were examined. The findings exposed that SAS was effective in anticipating short-term complications and served as factor for a long-term prognostic following multiple surgeries. While the SAS has been validated across various surgical subspecialties, based on the available evidence, the algorithm's modifications may be necessary to enhance its predictive accuracy within each specific subspecialty. Conclusions The SAS enables surgeons and anesthesiologists to recognize patients at a higher risk for certain complications or adverse events. By either modifying the SAS (Modified SAS) or combining it with ASA criteria, healthcare professionals can enhance their ability to identify patients who require continuous observation and follow-up as they go through the postoperative period. This approach would improve the accuracy of identifying individuals at risk and ensure appropriate measures to provide necessary care and support.

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Section: Discussionmentioning

confidence: 99%

Ability to predict surgical outcomes by surgical Apgar score: a systematic review

Mirzaiee,

Soleimani,

Banoueizadeh

et al. 2023

BMC Surg

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“…An additional postoperative re-scoring, e.g. in the recovery room, would possibly increase the predictive power [ 36 ]. Furthermore, although controversially discussed, biomarkers such as Brain Natriuretic Peptide (BNP), cardiac troponin, or blood urea nitrogen (BUN) may help estimating the patient’s risk for postoperative mortality and his or her individual benefit from advanced postsurgical monitoring and therapy [ 14 , 37 – 39 ].…”

Section: Discussionmentioning

confidence: 99%

The level of postoperative care influences mortality prediction by the POSPOM score: A retrospective cohort analysis

Menzenbach

Layer

et al. 2021

PLoS ONE

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Background The Preoperative Score to Predict Postoperative Mortality (POSPOM) assesses the patients’ individual risk for postsurgical intrahospital death based on preoperative parameters. We hypothesized that mortality predicted by the POSPOM varies depending on the level of postoperative care. Methods All patients age over 18 years undergoing inpatient surgery or interventions involving anesthesia at a German university hospital between January 2006, and December 2017, were assessed for eligibility for this retrospective study. Endpoint was death in hospital following surgery. Adaptation of the POSPOM to the German coding system was performed as previously described. The whole cohort was divided according to the level of postoperative care (normal ward vs. intensive care unit (ICU) admission within 24 h vs. later than 24 h, respectively). Results 199,258 patients were finally included. Observed intrahospital mortality was 2.0% (4,053 deaths). 9.6% of patients were transferred to ICU following surgery, and mortality of those patients was increased already at low POSPOM values of 15. 17,165 patients were admitted to ICU within 24 h, and these patients were older, had more comorbidities, or underwent more invasive surgery, reflected by a higher median POSPOM score compared to the normal-ward group (29 vs. 17, p <0.001). Mortality in that cohort was significantly increased to 8.7% (p <0.001). 2,043 patients were admitted to ICU later than 24 h following surgery (therefore denoted unscheduled admission), and the median POSPOM value of that group was 23. Observed mortality in this cohort was highest (13.5%, p <0.001 vs. ICU admission <24 h cohort). Conclusion Increased mortality in patients transferred to high-care wards reflects the significance of, e.g., intra- or early postoperative events for the patients’ outcome. Therefore, scoring systems considering only preoperative variables such as the POSPOM reveal limitations to predict the individual benefit of postoperative ICU admission.

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“…To date, the applicability of POSSUM and P-POSSUM scoring systems has been extensively explored in the colorectal and orthopedic specialties [13,14]. However, there is a dearth of research concerning the utilization of these scoring systems speci cally in patients undergoing emergency surgery.…”

Section: Introductionmentioning

confidence: 99%

An observational study to assess effectiveness of POSSUM and P-POSSUM score for prediction of morbidity and mortality after surgery for ileal perforation

Bhat,

Katkade

2023

Preprint

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Background: Perforative peritonitis is the most common surgical emergency. Most common perforation is seen in ileum, followed by duodenum, stomach, appendix, jejunum and colon. The methods of source control for ileal perforations include primary closure, resection, and anastomosis of small gut or diverting stoma, depending on the site and number of perforations, severity of peritonitis, and general condition of the patient. This study aims to assess the effectiveness of the POSSUM and P-POSSUM score in predicting morbidity and mortality following surgery for ileal perforation. And evaluate the correlation between the physiological factors and operative findings leading to morbidity and mortality for ileal perforation. Method: The study included all cases of ileal perforation undergoing surgery. Predicted morbidity and mortality scores were calculated based on physiologic and Operatives cores using POSSUM & P-POSSUM equations. Result: A total 40 patients were included in present study. Mean POSSUM morbidity was 95.45, while mean POSSUM mortality was 69.28. Significant association was found between physiological and operative score with fair correlation. Expected morbidity and mortality determined by POSSUM score showed values significantly above the observed ones. P-POSSUM score systems was effective in predicting mortality. Conclusion: POSSUM and P-POSSUM score can be used as good stratification tool for predicting morbidity and mortality in cases of ileal perforation respectively.

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CR-POSSUM and Surgical Apgar Score as predictive factors for patients’ allocation after colorectal surgery

Cited by 6 publications

References 25 publications

Ability to predict surgical outcomes by surgical Apgar score: a systematic review

Ability to predict surgical outcomes by surgical Apgar score: a systematic review

The level of postoperative care influences mortality prediction by the POSPOM score: A retrospective cohort analysis

An observational study to assess effectiveness of POSSUM and P-POSSUM score for prediction of morbidity and mortality after surgery for ileal perforation

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