Utility of a generic risk prediction score in predicting outcomes after orofacial surgery for cancer

Optimizing classical risk scores to predict complications in head and neck surgery: a new approach

“…The topic of surgical complications and mortality is a relatively delicate and difficult to report subject. However, our crude 30-day morbidity and mortality were broadly consistent with those in other published reports, at 45.3% and less than 1%, respectively [19][20][21]. Globally, the incidence of major postoperative complications according to the Clavien-Dindo classification (grade equal or superior to grade 3) was 14.8% (n = 19) which is also in line with other reports [19,20].…”

“…The findings in this study mirror those of Griffiths et al who, in a similar population, reported that POSSUM under-predicted morbidity in the low to moderate risk categories [21,26]. More recently, Tighe audited 360 operations in 245 patients submitted to orofacial surgery for cancer and concluded that P-POSSUM under-predicted morbidity in the low-risk groups and over-predicted mortality in all risk groups [20]. Unfortunately, in our study, P-POSSUM has revealed itself not suited to predict outcomes in head and neck surgery.…”

“…In our sample, P-POSSUM overpredicted 30-day mortality, as a total of eight deaths were predicted but only one occurred. Other authors reported that P-POSSUM overpredicted the occurrence of death and had no relevance in predicting mortality in a population undergoing head and neck surgery [20,26]. However, the analysis of mortality in our study is limited by the small number of patients who died in a relatively reduced sample.…”

Evaluation and validation of Physiological and Operative Severity Score for the enumeration of mortality and morbidity and Portsmouth‐POSSUM scores in predicting morbidity and mortality in patients undergoing head and neck cancer surgeries

“…Majority of our patients were male, similar to other studies which included head and neck cancer surgery patients. 9,15,16 Our study population was relatively younger as compared to other studies. 16 In the current study, majority of patients were diagnosed to have oral cavity lesions followed by thyroid cancer as opposed to other studies which included only specific primary sites hence our study has data related to a broad spectrum of head and neck oncosurgeries.…”

Is benchmarking possible in audit of early outcomes after operations for head and neck cancer?

“…It remains to be seen whether these scores discriminate more effectively than HES data models, or generic surgical scores including POSSUM (physiological and operative severity score for the enumeration of mortality and morbidity) scores, which have shown reasonable discriminatory power in similar groups. 27 The study has several weaknesses. The dataset from Site A is not strictly comparable with the more recent datasets from Sites B and C. Clearly, interpretation of the relative performance of Site A to Sites B and C must take into consideration the time period being assessed and the changes in medical practice that have been adopted since.…”