TY - JOUR
T1 - Morbimortality assessment in abdominal surgery
T2 - are we predicting or overreacting?
AU - Valenzuela, Sebastian
AU - Niño, Laura
AU - Conde, Danny
AU - Girón, Felipe
AU - Rodríguez, Lina
AU - Venegas, David
AU - Rey, Carlos
AU - Nassar, Ricardo
AU - Vanegas, Marco
AU - Jiménez, Daniel
N1 - © 2022. The Author(s).
PY - 2022/1/18
Y1 - 2022/1/18
N2 - Background: High-risk surgical procedures represent a fundamental part of general surgery practice due to its significant rates of morbidity and mortality. Different predictive tools have been created in order to quantify perioperative morbidity and mortality risk. POSSUM (Physiological and Operative Severity Score for the enumeration of Mortality and morbidity) is one of the most widely validated predictive scores considering physiological and operative variables to precisely define morbimortality risk. Nevertheless, seeking greater accuracy in predictions P-POSSUM was proposed. We aimed to compare POSSUM and P-POSSUM for patients undergoing abdominal surgery. Methods: A retrospective observational study with a prospective database was conducted. Patients over 18 years old who complied with inclusion criteria between 2015 and 2016 were included. Variables included in the POSSUM and P-POSSUM Scores were analyzed. Descriptive statistics of all study parameters were provided. The analysis included socio-demographic data, laboratory values , and imaging. Bivariate analysis was performed. Results: 350 Patients were included in the analysis, 55.1% were female. The mean age was 55.9 ± 20.4 years old. POSSUM revealed a moderated index score in 61.7% of the patients, mean score of 12.85 points ± 5.61. 89.1% of patients had no neoplastic diagnosis associated. Overall morbidity and mortality rate was 14.2% and 7.1%. P-POSSUM could predict more precisely mortality (p < 0.00). Conclusions: The POSSUM score is likely to overestimate the risk of morbidity and mortality in patients with high/moderate risk, while the P-POSSUM score seems to be a more accurate predictor of mortality risk. Further studies are needed to confirm our results.
AB - Background: High-risk surgical procedures represent a fundamental part of general surgery practice due to its significant rates of morbidity and mortality. Different predictive tools have been created in order to quantify perioperative morbidity and mortality risk. POSSUM (Physiological and Operative Severity Score for the enumeration of Mortality and morbidity) is one of the most widely validated predictive scores considering physiological and operative variables to precisely define morbimortality risk. Nevertheless, seeking greater accuracy in predictions P-POSSUM was proposed. We aimed to compare POSSUM and P-POSSUM for patients undergoing abdominal surgery. Methods: A retrospective observational study with a prospective database was conducted. Patients over 18 years old who complied with inclusion criteria between 2015 and 2016 were included. Variables included in the POSSUM and P-POSSUM Scores were analyzed. Descriptive statistics of all study parameters were provided. The analysis included socio-demographic data, laboratory values , and imaging. Bivariate analysis was performed. Results: 350 Patients were included in the analysis, 55.1% were female. The mean age was 55.9 ± 20.4 years old. POSSUM revealed a moderated index score in 61.7% of the patients, mean score of 12.85 points ± 5.61. 89.1% of patients had no neoplastic diagnosis associated. Overall morbidity and mortality rate was 14.2% and 7.1%. P-POSSUM could predict more precisely mortality (p < 0.00). Conclusions: The POSSUM score is likely to overestimate the risk of morbidity and mortality in patients with high/moderate risk, while the P-POSSUM score seems to be a more accurate predictor of mortality risk. Further studies are needed to confirm our results.
KW - Adolescent
KW - Adult
KW - Aged
KW - Female
KW - Humans
KW - Middle Aged
KW - Morbidity
KW - Postoperative Complications/epidemiology
KW - Retrospective Studies
KW - Risk Assessment
KW - Severity of Illness Index
UR - http://www.scopus.com/inward/record.url?scp=85123001984&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/e18a89b8-0bfb-3bbe-bd39-00851e374b70/
U2 - 10.1186/s12893-021-01455-1
DO - 10.1186/s12893-021-01455-1
M3 - Artículo
C2 - 35042495
AN - SCOPUS:85123001984
SN - 1471-2482
VL - 22
SP - 19
JO - BMC Surgery
JF - BMC Surgery
IS - 1
M1 - 19
ER -