A Model for National Outcome Audit in Vascular Surgery

Prytherch, David; Ridler, B. M. F.; Beard, J. D.; Earnshaw, J. J.

doi:10.1053/ejvs.2001.1369

Cited by 92 publications

(40 citation statements)

References 13 publications

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“…In 2001 the Vascular Surgical Society of Great Britain and Ireland conducted an audit of 1345 vascular operations. One finding was that the physiological element of the POSSUM score predicted outcome of surgery as well as the total score with the operative element [35]. Neary et al showed that the POSSUM physiology score alone could predict the outcome of intra-arterial thrombolysis for acute leg ischaemia [36] and the same group in 2003 showed that the physiological POSSUM score predicted outcome for ruptured AAA surgery [37].…”

Section: Pre-operative Scoring Systemsmentioning

confidence: 99%

Pre-operative risk scores for the prediction of outcome in elderly people who require emergency surgery

Rix

Bates

2007

World J Emerg Surg

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Section: Pre-operative Scoring Systemsmentioning

confidence: 99%

Pre-operative risk scores for the prediction of outcome in elderly people who require emergency surgery

Rix

Bates

2007

World J Emerg Surg

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“…[6] was recommended as the most appropriate for general surgery [7,8]. This model, utilizing scores relating to twelve physiological and six operative variables, was developed to predict in-hospital mortality and morbidity postoperatively.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the POSSUM, P-POSSUM and E-PASS scores in the surgical treatment of hilar cholangiocarcinoma

Wang

Chen

et al. 2014

World J Surg Onc

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BackgroundThe Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) model, its Portsmouth (P-POSSUM) modification and the Estimation of physiologic ability and surgical stress (E-PASS) are three surgical risk scoring systems used extensively to predict postoperative morbidity and mortality in general surgery. The aim was to undertake the first study of the predictive value of these models in patients undergoing surgical treatment of hilar cholangiocarcinoma.MethodsA retrospective analysis was performed on data collected prospectively over a 10-year interval from January 2003 to December 2012. The morbidity and mortality risks were calculated using the POSSUM, P-POSSUM and E-PASS equations.ResultsOne hundred patients underwent surgical treatment of hilar cholangiocarcinoma. Complications were seen in 52 of 100 patients (52.0%). There were 10 postoperative in-hospital deaths (10.0%). Of 31 preoperative and intraoperative variables studied, operative type (P = 0.000), preoperative serum albumin (P = 0.003) and aspartate aminotransferase (P = 0.029) were found to be factors multivariate associated with postoperative complications. Intraoperative blood loss (P = 0.015), Bismuth-Corlette classification (P = 0.033) and preoperative hemoglobin (P = 0.041) were independent factors multivariate associated with in-hospital death. The POSSUM system predicted morbidity risk effectively with no significant lack of fit (P = 0.488) and an area under the ROC curve (AUC) of 0.843. POSSUM, P-POSSUM and E-PASS scores showed no significant lack of fit in calculating the mortality risk (P >0.05) and all yielded an AUC value exceeding 0.8. POSSUM had significantly more accuracy in predicting morbidity after major and major plus operations (O:E (observed/expected) ratio 0.98 and AUC 0.901) than after minor and moderate operations (O:E ratio 1.13 and AUC 0.759).ConclusionsPOSSUM, P-POSSUM and E-PASS scores effectively predict morbidity and mortality in surgical treatment of hilar cholangiocarcinoma. However, improvements are still needed in the future because none of these scoring systems yielded an AUC value exceeding 0.9 for operations with all different levels of severity. Only POSSUM had more accuracy in predicting postoperative morbidity after operations with higher severity.Trial registrationThis study was undertaken after obtaining approval from the ethics committee of School of Medicine, Shanghai Jiao Tong University with a trial registration number of http://09411960800.

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“…To counteract these limitations, specialty-specific models based on the POSSUM methodology have been developed and applied in arterial surgery 11,12 (V-POSSUM) and oesophagogastric surgery (O-POSSUM) 10 .…”

Section: Introductionmentioning

confidence: 99%

Development of a dedicated risk-adjustment scoring system for colorectal surgery (colorectal POSSUM)

Tekkis

Prytherch

Kocher

et al. 2004

British Journal of Surgery

313

249

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A Model for National Outcome Audit in Vascular Surgery

Cited by 92 publications

References 13 publications

Pre-operative risk scores for the prediction of outcome in elderly people who require emergency surgery

Pre-operative risk scores for the prediction of outcome in elderly people who require emergency surgery

Evaluation of the POSSUM, P-POSSUM and E-PASS scores in the surgical treatment of hilar cholangiocarcinoma

Development of a dedicated risk-adjustment scoring system for colorectal surgery (colorectal POSSUM)

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