Morbimortality assessment in abdominal surgery: are we predicting or overreacting?

Sebastian Valenzuela, Laura Niño, Danny Conde, Felipe Girón, Lina Rodríguez, David Venegas, Carlos Rey, Ricardo Nassar, Marco Vanegas, Daniel Jiménez

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1 Scopus citations


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.
Original languageEnglish
Article number19
Pages (from-to)19
JournalBMC Surgery
Issue number1
StatePublished - 18 Jan 2022


  • Adolescent
  • Adult
  • Aged
  • Female
  • Humans
  • Middle Aged
  • Morbidity
  • Postoperative Complications/epidemiology
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index


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