A Comparison of POSSUM, P-POSSUM and Colorectal POSSUM for the Prediction of Postoperative Mortality in Patients Undergoing Colorectal Resection

Ramkumar, Thangiah; Ng, Vivien; Fowler, Lucy; Farouk, Ridzuan

doi:10.1007/s10350-005-0290-7

Cited by 34 publications

(25 citation statements)

References 16 publications

(24 reference statements)

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“…CR-POSSUM is a specific scoring system for colorectal cancer and is more reliable but still needs further adjustment [15,16]. In an attempt to improve the validity of POSSUM, we analysed the effect it has over different variables classically associated with surgical morbidity.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, in an attempt to assess the internal consistency of POSSUM scoring system and guided by the work of Ramkumar [15], we validated the precision of POSSUM, using stratified risk intervals (Table 7). We have seen that when the expected proportion of complications in POS SUM increases, the number of patients with complications in our study increased also.…”

Section: Discussionmentioning

confidence: 99%

“…This fact led to the development, in 2004, of the CR-POSSUM, which is specific for colorectal surgery [13]. It seems to be the most accurate scoring system, compared with the previous ones [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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Analysis of POSSUM score and postoperative morbidity in patients with rectal cancer undergoing surgery

Valentí

Hernández-Lizoain

Baixauli

et al. 2008

Langenbecks Arch Surg

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Background The Physiological and Operative Severity Score for the enUmeration of Mortality andmorbidity (POSSUM) and later modifications (P-POSSUM y CRPOSSUM) have been used to predictmorbidity and mortality rates among patients with rectal cancer undergoing surgery. These calculations needsome adjustment, however. The aim of this study was to assess the applicability of POSSUM to a group ofpatients with rectal cancer undergoing surgery, analysing surgical morbidity by means of several variables. Methods between January 1995 and December 2004, 273 consecutive patients underwent surgery forrectal cancer. Information was gathered about the patients, tumour and therapy. To assess the predictioncapacity of POSSUM, subgroups for analysis were created according to variables related to operativemorbidity and mortality. Results The global morbidity rate was 23.6% (31.2% predicted by POSSUM). The mortality rate was 0.7% (6.64, 1.95 and 2.08 predicted by POSSUM, P-POSSUM and CR-POSSUM respectively). POSSUMpredictions may be more accurate for patients younger than 51 years, older than 70 years, with low anaesthetic risk (ASA I/II), DUKES stage C and D, surgery duration of less than 180 minutes and for thosereceiving neoadjuvant therapy. Conclusion POSSUM is a good instrument to make results between different institutions and publicationcomparable. We found prediction errors for some variables related to morbidity. Modifications of surgicalvariables and specifications for neoadjuvant therapy as well as physiological variables including life stylemay improve future prediction of surgical risk. More research is needed to identify further potential riskfactors for surgical complications.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Analysis of POSSUM score and postoperative morbidity in patients with rectal cancer undergoing surgery

Valentí

Hernández-Lizoain

Baixauli

et al. 2008

Langenbecks Arch Surg

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“…[17] The specialty-specific CR POSSUM (CR-POSSUM), which uses 10 measures (6 physiological and 4 operative), was developed in 2004 and is easier to use, more accurate, and has been validated. [18] Ferjani et al . compared POSSUM-based scoring systems to the ACPGSI (Association of Coloproctology of Great Britain and Ireland) score.…”

Section: Introductionmentioning

confidence: 99%

Anesthesia and perioperative management of colorectal surgical patients - A clinical review (Part 1)

Patel¹,

Lutz²,

Panchagnula³

et al. 2012

J Anaesthesiol Clin Pharmacol

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Colorectal surgery is commonly performed for colorectal cancer and other pathology such as diverticular and inflammatory bowel disease. Despite significant advances, such as laparoscopic techniques and multidisciplinary recovery programs, morbidity and mortality remain high and vary among surgical centers. The use of scoring systems and assessment of functional capacity may help in identifying high-risk patients and predicting complications. An understanding of perioperative factors affecting colon blood flow and oxygenation, suppression of stress response, optimal fluid therapy, and multimodal pain management are essential. These fundamental principles are more important than any specific choice of anesthetic agents. Anesthesiologists can significantly contribute to enhance recovery and improve the quality of perioperative care.

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“…The Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM), including variations, is well established as a stratification tool in comparative surgical audits [5,6,7,8,9,10,11,12,13,14,15,16,17,18]. In these studies mortality and morbidity are correlated to increasing POSSUM scores.…”

Section: Introductionmentioning

confidence: 99%

POSSUM Predicts Survival in Patients with Unresectable Pancreatic Cancer

Castro¹,

Houwert²,

Lagard³

et al. 2009

Dig Surg

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Background: The aim of this study was to evaluate the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) for patients with unresectable pancreatic cancer and to analyze whether POSSUM can predict the long-term outcome in these patients. Such a scoring system could be useful to aid in the decision between surgical and endoscopic palliation. Methods: Between January 1993 and December 2004, 241 patients were found to have unresectable pancreatic cancer during exploratory laparotomy and underwent a double bypass procedure consisting of a gastrojejunostomy and a hepaticojejunostomy. Results: Overall, 64 of 240 patients (27%) had one or more complications after bypass surgery and 4 patients (2%) died. POSSUM predicted morbidity in 114 patients (47%). The observed:predicted (O:P) ratio for morbidity was 0.56 and the model had a significant lack of fit (p < 0.001) using a goodness-of-fit analysis. The overall median survival was 7 months. The POSSUM scoring system was, however, an independent predictor of survival in multivariate analysis. Conclusions: Overall, POSSUM overpredicted morbidity but was an independent predictor of survival.

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A Comparison of POSSUM, P-POSSUM and Colorectal POSSUM for the Prediction of Postoperative Mortality in Patients Undergoing Colorectal Resection

Abstract: Colorectal POSSUM provides comparable prediction of mortality risk after colorectal resection compared with POSSUM and P-POSSUM.

Cited by 34 publications

References 16 publications

Analysis of POSSUM score and postoperative morbidity in patients with rectal cancer undergoing surgery

Analysis of POSSUM score and postoperative morbidity in patients with rectal cancer undergoing surgery

Anesthesia and perioperative management of colorectal surgical patients - A clinical review (Part 1)

POSSUM Predicts Survival in Patients with Unresectable Pancreatic Cancer

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