Evaluation of POSSUM and P-POSSUM scoring systems in patients undergoing colorectal surgery

Tekkis, Paris; Kessaris, Nicos; Kocher, Hemant M.; Poloniecki, Jan; Lyttle, J. A.; Windsor, Alastair

doi:10.1002/bjs.4037

Cited by 104 publications

(74 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The Physiologic and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) scoring system was used to identify patient-related risk factors and to provide an objective measure for the assessment of morbidity and mortality data [33,34,35]. The physiologic score (PS) and operative severity score (OSS) were calculated for each patient.…”

Section: Methodsmentioning

confidence: 99%

Reversal of Hartmann’s Procedure after Surgery for Complications of Diverticular Disease of the Sigmoid Colon Is Safe and Possible in Most Patients

2005

View full text Add to dashboard Cite

Background: Although evidence is growing that most patients who need an operation for diverticular disease of the sigmoid colon can be treated by a single-stage procedure, a two-stage procedure will still be necessary in some patients because of significant sepsis or technical difficulties. The outcomes of 65 patients who underwent secondary restoration after a Hartmann procedure for complicated diverticulitis were studied and the factors leading to complications and mortality were identified. Patients and Methods: Of 91 patients, in a consecutive 12-year period, whose primary operation was a Hartmann procedure, 72 survived longer than 3 months after discharge. Sixty-five underwent an attempted reversal of the Hartmann procedure. The POSSUM scores were calculated in all patients as well as the morbidity and mortality rates. Results: In 63 (96.9%) patients the bowel continuity could be restored with a morbidity of 38.5% and a mortality of 3.1%. The POSSUM and p-POSSUM scores adequately predicted the mortality in this series. Conclusion: This series shows that when surgical treatment for complicated diverticular disease of the sigmoid colon is necessary, the Hartmann procedure is still a valid indication. In a high percentage of patients the Hartmann procedure could be restored with a low mortality.

show abstract

Section: Methodsmentioning

confidence: 99%

Reversal of Hartmann’s Procedure after Surgery for Complications of Diverticular Disease of the Sigmoid Colon Is Safe and Possible in Most Patients

2005

View full text Add to dashboard Cite

show abstract

“…Although they have been applied to patients undergoing general, colorectal and vascular surgery, the performance of POSSUM and p-POSSUM in patients 90 years of age and older has not been validated. 7,[9][10][11][12][13] The objectives of our study were to determine the outcomes of elective and emergency abdominal surgery in patients 90 years of age or older and to assess the performance of the POSSUM and p-POSSUM systems as predictors of mortality.…”

mentioning

confidence: 99%

Elective and emergency abdominal surgery in patients 90 years of age or older

et al. 2012

View full text Add to dashboard Cite

Elective and emergency abdominal surgery in patients 90 years of age or olderBackground: Few studies have examined perioperative outcomes in nonagenarians undergoing abdominal surgery, and fewer have reported on 1-year mortality. Our objectives were to determine the outcomes of abdominal surgery in nonagenarians and to assess the performance of Physiologic and Operative Severity Score for enUmeration of Mortality and morbidity (POSSUM) and Portsmouth-POSSUM (p-POSSUM) as predictors of mortality. Methods:We conducted a retrospective chart review of all patients 90 years and older who underwent abdominal surgery between 2000 and 2007 at a tertiary care hospital. Results:We included 145 patients (median age 91, range 90-101 yr). The most common diagnoses were colorectal cancer (19.3%) and hernias (19.3%), and the most common procedures were bowel resection with anastomosis (25.5%) and hernia repair (18.6%). Overall in-hospital mortality was 15.2% (20.8% in the emergent group and 9.6% in the elective group; p = 0.06). The 1-year mortality (49.1% v. 27.8%; p = 0.016), complication (81.9% v. 61.6%; p = 0.007) and intensive care unit admission rates (44.4% v. 11.0%; p < 0.001) were significantly higher among emergent than elective surgical patients. The operative indications and procedures associated with the highest in-hospital mortality were large bowel obstruction (42.3%) and bowel resection with anastomosis (27.0%). Both the POSSUM and p-POSSUM scoring systems significantly overpredicted mortality, particularly in higher risk groups. Conclusion:Nonagenarians undergoing abdominal surgery have substantial operative morbidity and mortality, particularly in emergent surgical cases. Nearly 50% of patients who undergo emergency procedures die within 1 year after surgery. The POSSUM and p-POSSUM scoring systems were not reliable predictors of in-hospital mortality.Contexte : Peu d'études se sont penchées sur les résultats périopératoires de la chirurgie abdominale chez les nonagénaires, et moins encore ont mesuré leur mortalité à 1 an. Nous avions pour objectifs de déterminer l'issue de la chirurgie abdominale chez les nonagénaires et de mesurer les indices POSSUM (Physiologic and Operative Severity Score for enUmeration of Mortality and morbidity) et p-POSSUM (Portsmouth-POSSUM) en tant que prédicteurs de la mortalité. Résultats : Nous avons inclus 145 patients (âge médian 91 ans, éventail de 90 à 101 ans). Les diagnostics les plus fréquents étaient le cancer colorectal (19,3 %) et les hernies (19,3 %), tandis que les interventions les plus courantes ont été la résection intestinale avec anastomose (25,5 %) et la réparation de hernie (18,6 %). La mortalité perhospitalière globale a été de 15,2 % (20,8 % dans le groupe ayant subi une intervention d'urgence et de 9,6 % dans le groupe ayant subi une intervention élective; p = 0,06). Les taux à 1 an pour ce qui est de la mortalité (49,1 % c. 27,8 %; p = 0,016), des complications (81,9 % c. 61,6 %; p = 0,007) et des admissions aux unités de soins intensifs (44,4 % c. 11,0 %; ...

show abstract

“…To overcome this shortcoming POSSUM, a risk adjusted scoring system was proposed5.P-POSSUM, a modification of POSSUM, has been proposed as a better scoring system as it better correlates with the observed mortality rate. But P-POSSUM has to be correlated to the general condition of the local population for it to be effective 7,8,14,15,19,21 .This is especially true in patients in developing countries like India where the general health of the population is poor, malnutrition is a common problem and presentation frequently delayed.In our study, we assessed the validity of P POSSUM in 200 surgeries by comparing the mortality rate and morbidity rate with actual observed death and complications. 36 patients died (crude mortality of 18%).…”

Section: Discussionmentioning

confidence: 99%

Portsmouth Possum Scoring in General Surgery, identifying Risk Factors for low outcome And Predicting Post operative Mortality

Mathai¹,

Bhagavan²,

Shishira³

2017

IOSR JDMS

View full text Add to dashboard Cite

show abstract

Evaluation of POSSUM and P-POSSUM scoring systems in patients undergoing colorectal surgery

Cited by 104 publications

References 17 publications

Reversal of Hartmann’s Procedure after Surgery for Complications of Diverticular Disease of the Sigmoid Colon Is Safe and Possible in Most Patients

Reversal of Hartmann’s Procedure after Surgery for Complications of Diverticular Disease of the Sigmoid Colon Is Safe and Possible in Most Patients

Elective and emergency abdominal surgery in patients 90 years of age or older

Portsmouth Possum Scoring in General Surgery, identifying Risk Factors for low outcome And Predicting Post operative Mortality

Contact Info

Product

Resources

About