POSSUM for the Prediction of Mortality and Morbidity in Infra-renal Abdominal Aortic Aneurysm Repair. The Hastings Experience

Shuhaiber, Jeffrey; Hankins, Matthew; Robless, Peter; Whitehead, S.M.

doi:10.1053/ejvs.2001.1439

Cited by 5 publications

(3 citation statements)

References 5 publications

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“…A previous paper 19 has attempted to use POSSUM to challenge the long heated debate of repairing AAA in either a dedicated unit within a teaching hospital or district general hospital. 20 POSSUM, P-POSSUM and V-POSSUM all suffer from the weakness which is, by definition, they exclude patients who were either not offered or refused surgery.…”

Section: Discussionmentioning

confidence: 99%

POSSUM Models in Open Abdominal Aortic Aneurysm Surgery

Tang

Walsh

Prytherch

et al. 2007

European Journal of Vascular and Endovascular Surgery

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Section: Discussionmentioning

confidence: 99%

POSSUM Models in Open Abdominal Aortic Aneurysm Surgery

Tang

Walsh

Prytherch

et al. 2007

European Journal of Vascular and Endovascular Surgery

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“…PatientsÕ functional capacity is determined subjectively by the internist. Risk stratification is done according to modified Possum guidelines [8].…”

Section: Discussionmentioning

confidence: 99%

No increase in mortality after open infrarenal aortic surgery in the era of evar

et al. 2011

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The mortality rate for elective infrarenal aortic surgery is on the order of 5%-7%. Most deaths are related to coronary heart disease (CAD). Significant coronary heart disease is present in some 60% of patients who need elective aortic operations. Risk-stratification scales are not particularly helpful in finding CAD. It is generally assumed that since the more straightforward cases are managed by endoprosthesis, the mortality rate related to open repair may be on the rise. We report 218 consecutive elective infrarenal aortic operations performed at the Swiss Cardiovascular Center (University Hospital, Berne) between 1998 and 2001. There were 36 (17%) females and 182 (83%) males, mean age 66.7 years (range 42-86 years). Of the patients, 87 (40%) were older than 70, 35 (16%) older than 75 years of age. A prior myocardial infarction was diagnosed in 42 (19%), 141 (65%) were hypertensive, 20 (9%) had diabetes mellitus (IDDM), 24 (11%) renal insufficiency (creatinin >13 mg/ dL) and 79 (36%) chronic obstructive pulmonary disease (COPD). The initial screening was done by an in-house internist. As a result, 179 patients (82%) underwent cardiological evaluation, which in turn led to 71 (33%) stress echocardiographies, and subsequently 47 (22%) coronary angiographies. This in turn led to coronary revascularization in 24 (11%). Five carotid endarterectomies (2.3%) were performed prior to planned aortic surgery. There was no mortality related to these operations. Aneurysm repair was performed in 165 (76%) patients, surgery for atherosclerotic lesions in 53 (24%). In-hospital mortality was 1 (0.5%). There was no further 30-day mortality. We conclude that the results of open infrarenal aortic surgery can be improved by active screening by an in-house internist and treatment of underlying vascular and lung disease. This should be reflected in reimbursement policies.

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“…Le POSSUM (Physiologic andOperative Severity Score for the enUmeration of Mortality and morbidity) est un score prédictif de mortalité qui a été largement utilisé en chirurgie aortique et abdominale élective [ 1 , 2 ]. Ce score serait un bon facteur prédictif de mortalité à partir d'un certain seuil dans différentes situations chirurgicales (chez le cirrhotique [ 3 ], en urgence [ 4 ]).…”

Section: Introductionunclassified

Le POSSUM: un bon score pour prédire la mortalité du sujet âgé opéré en urgence?

Mzoughi¹,

Bayar²,

Djebbi³

et al. 2016

Pan Afr Med J

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IntroductionLe POSSUM (Physiologic and Operative Severity Score for the enUmeration of Mortality and morbidity) est un score prédictif de mortalité qui est largement utilisé en chirurgie aortique élective et abdominale. Le but de notre étude est une validation du POSSUM chez le sujet âgé (>70 ans) opéré pour une urgence digestive. Nous nous proposons d'étudier les meilleurs seuils du POSSUM, composé d'un score physiologique et d'un score opératoire, pour prédire la mortalité dans cette population.MéthodesIl s'agit d'une étude rétrospective analytique de type cas témoin à partir d'une série de 291 patients d'âge ≥ 70 ans opérés pour une urgence digestive. Ces patients étaient répartis en deux groupes comportant 50 patients chacun. Le groupe "DC": patients décédés en post opératoire immédiat et le Groupe témoin "SURV" choisis par tirage au sort. Nous avons analysé la fiabilité du POSSUM pour prédire la mortalité et la morbidité. Par la suite, nous avons établi des courbes de ROC pour définir les seuils qui donnent le meilleur couple sensibilité/spécificité.RésultatsLe score physiologique, le score opératoire et les taux de morbidité et mortalité prédits par POSSUM et la mortalité prédit par P-POSSUM représentaient des facteurs prédictifs de mortalité (P <0,0001). Les valeurs seuils du score physiologique et du score opératoire qui donnent le meilleur couple sensibilité/spécificité, étaient respectivement de 23 et 15.ConclusionPrédire la mortalité permet de cibler la prise en charge et d'informer le patient et sa famille des risques encourus.

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POSSUM for the Prediction of Mortality and Morbidity in Infra-renal Abdominal Aortic Aneurysm Repair. The Hastings Experience

Cited by 5 publications

References 5 publications

POSSUM Models in Open Abdominal Aortic Aneurysm Surgery

POSSUM Models in Open Abdominal Aortic Aneurysm Surgery

No increase in mortality after open infrarenal aortic surgery in the era of evar

Le POSSUM: un bon score pour prédire la mortalité du sujet âgé opéré en urgence?

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