Elderly POSSUM, a dedicated score for prediction of mortality and morbidity after major colorectal surgery in older patients

Loc, Pierre Tran Ba; Montcel, Sophie Tezenas du; Duron, Jean‐Jacques; Levard, H; Suc, B.; Descottes, B; Desrousseaux, B; Hay, Jean‐Marie

doi:10.1002/bjs.6903

Cited by 53 publications

(27 citation statements)

References 44 publications

(70 reference statements)

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“…The elderly typically have increased comorbidities and the adjusted E-POSSUM score shows good performance in major colorectal surgery, although not specifically in the emergency setting [50].…”

Section: Identifying the 'High-risk' Emergency Patientmentioning

confidence: 99%

Organisation and planning of anaesthesia for emergency surgery

Gray

Morris

2012

Anaesthesia

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SummaryPatients presenting for emergency surgery represent a category at high risk of complications, with substantial morbidity and mortality, whose management may be extremely challenging. In this first of two articles we consider the identification and evaluation of high risk emergency patients, the provision of critical care support, the management of sepsis, common postoperative complications and in‐theatre death.

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Section: Identifying the 'High-risk' Emergency Patientmentioning

confidence: 99%

Organisation and planning of anaesthesia for emergency surgery

Gray

Morris

2012

Anaesthesia

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“…To evaluate the risk level of surgical operation, Copeland et al [5] developed the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) scoring system, in which 12 physiological and 6 operative factors are scored and subjected to logistic regression analysis to generate two equations to predict mortality and morbidity. Since this pioneering study, there have been various modifications to the scoring system in various surgical fields [2,20,21,24]. In 2002, the original POSSUM equation (using a modified operation classification) was validated in orthopedic surgery [19].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a Modified POSSUM Scoring System for Predicting the Morbidity in Patients Undergoing Lumbar Surgery

Li¹,

Bai

et al. 2013

Indian J Surg

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For most spine surgeons, operative intervention is common for the treatment of lumbar disc herniation, lumbar stenosis, lumbar fracture or lumbar spondylolisthesis. However, with the increase in lumbar surgery, the complication rate increases accordingly. Whereas the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) scoring system has been widely used to predict morbidity in various surgical fields, the application of this system in lumbar surgery has not been reported. From January 2008 to January 2010, we recruited 158 patients (85 males and 73 females) with operation for lumbar disc herniation, lumbar stenosis, lumbar fracture, or lumbar spondylolisthesis. All patients were analyzed to compare the morbidity by a modified POSSUM scoring system. According to the modified POSSUM, the expected morbidity was 51 cases (32.3 %), whereas the observed mortality was 42 cases (26.6 %). The overall observed-to-expected ratio was 0.82, and the chi-squared test indicated no statistically significant difference between the expected and observed morbidities (χ 2 =1.23, P=0.27), suggesting that the modified POSSUM can accurately estimate the outcome. The modified POSSUM scoring system we developed is a useful tool for predicting and evaluating morbidity in lumbar surgery. Further studies are required to investigate whether this scoring system can predict mortality.

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“…28 Additionally, it has also been shown to closely correlate with surgical and oncologic outcomes. 3 Another predictive formula for elderly colorectal patients has been validated and is in wide use, 4 however no scoring system yet exists specifically for patients with pancreatic neoplasm. Table 2 summaries known risk factors that are germane to the pre-operative evaluation of elderly patients.…”

Section: Patient Selection and The Need For A Multi-disciplinary Apprmentioning

confidence: 99%

“…Several scoring systems have been developed to predict outcomes in elderly patients with cancer diagnoses and include variables such as nutritional status, laboratory values, cardiopulmonary status, timed "get up and go" testing, and American Society of Anesthesiologists (ASA) status. 3,4 Further confounding the discussion of the elderly patient with pancreatic cancer is the wide variety of pathology (pancreatic adenocarcinoma, neuroendocrine tumors, mucinous neoplasms, peri-ampullary or duodenal tumors) combined with anatomic considerations (lesions in the head vs. body vs. tail) and the implications for surgical resection, research, and outcomes. In our practice we do not define elderly at a specific age, but rather take into account every patient's comorbidities, functional level, and nutritional status.…”

Section: Introductionmentioning

confidence: 99%

Pancreatic Cancer in the Very Elderly Patient: Challenges and Solutions

Bellevue¹,

Johnson²,

Feczko³

et al. 2016

Surg Res Open J

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Pancreatic cancer is responsible for a significant disease burden on the aging US population. The only chance at curing this highly morbid disease is surgical resection, however choosing appropriate surgical candidates in the elderly population remains challenging. We review the literature for appropriate treatment modalities to the elderly patient. Although significant literature exists in choosing appropriate surgical candidates as well as managing those not deemed fit for surgery, the medical community is not unified when approaching these patients. Further collaboration between the surgical, medical, and palliative communities will likely spawn better outcomes for less overall health care cost in the future.

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Elderly POSSUM, a dedicated score for prediction of mortality and morbidity after major colorectal surgery in older patients

Abstract: The E-POSSUM is a good tool for predicting mortality, and the only efficient scoring system for predicting morbidity after major colorectal surgery in the elderly.

Cited by 53 publications

References 44 publications

Organisation and planning of anaesthesia for emergency surgery

Organisation and planning of anaesthesia for emergency surgery

Evaluation of a Modified POSSUM Scoring System for Predicting the Morbidity in Patients Undergoing Lumbar Surgery

Pancreatic Cancer in the Very Elderly Patient: Challenges and Solutions

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