Background: The physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) is a scoring system previously validated in vascular and general surgical patients. The Portsmouth phy...Background: The physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) is a scoring system previously validated in vascular and general surgical patients. The Portsmouth physiological and operative severity score for the enumeration of mortality and morbidity (P-POSSUM) is a reliable tool derived from POSSUM to improve the prediction of mortality. In this paper, we utilized both models to determine the most suitable and feasible one that could be utilized in orthopedic surgery in China mainland. Methods: In this retrospective study, patients’ files were extracted randomly from the medical records department of the First Hospital Affiliated with Dalian Medical University for those underwent hip replacements between 1999 and 2006. The mortality and morbidity rates were predicted by P-POSSUM and POSSUM, respectively. A comparative analysis was performed between the observed and the predicted values as well as the Observed/Expected ratio (O:E). Results: A total of 206 patients were selected for this study after fulfilling the inclusion and exclusion criteria. The predicted mortality by P-POSSUM were not significantly different from the observed values (X2 = 2.10, P = 0.552). POSSUM appeared to be better with the observed morbidity (X2 = 2.766, P = 0.598), but had overestimated mortality. Conclusion: The POSSUM morbidity equation satisfactorily estimated the risk of postoperative complications, and the P-POSSUM mortality equation appeared to stratify the risk of death more accurate than the POSSUM.展开更多
背景与目的对于评价老年患者能否耐受肺癌手术,目前尚无明确标准。本研究旨在探讨改良POSSUM(Physiological and Operative Severity Score for the Umeration of Mortality and Morbidity)评分在预测老年非小细胞肺癌(non-small cell l...背景与目的对于评价老年患者能否耐受肺癌手术,目前尚无明确标准。本研究旨在探讨改良POSSUM(Physiological and Operative Severity Score for the Umeration of Mortality and Morbidity)评分在预测老年非小细胞肺癌(non-small cell lung cancer,NSCLC)患者术后并发症发生率和病死率中的应用价值,为手术治疗的决策提供重要依据。方法 2007年12月-2013年12月在解放军总医院接受手术治疗的老年NSCLC患者138例,其中男性88例,女性50例,收集临床资料,各因素对术后实际并发症发生率和病死率的影响,采用二值多元Logistic回归分析。在有、无并发症两组中,采用成组t检验对标准及改良POSSUM评分值进行比较。绘制标准POSSUM和改良POSSUM的受试者工作特征曲线(receiver operating characteristic curve,ROC),计算曲线下面积(area under the curve,AUC),两组间AUC比较采用t检验。计算改良POSSUM评分预测值和实际并发症发生率和病死率的符合度。结果共有59例患者出现77例次术后并发症,手术死亡2例。Logistic回归分析,标准POSSUM的18项指标中17项及肺功能、肿瘤分期对术后并发症的发生有统计学意义(P<0.05),年龄对术后死亡有统计学意义(P<0.05)。在标准POSSUM评分中,并发症组与无并发症组的评分比较,差异有统计学意义(P<0.01)。在改良POSSUM评分中,并发症组与无并发症组的评分比较,差异有统计学意义(P<0.01)。改良POSSUM较标准POSSUM对术后并发症发生有更好的预测价值,两组AUC比较,差异有统计学意义(P<0.01)。但改良POSSUM对手术死亡的预测值过高。结论改良POSSUM评分对老年NSCLC术后并发症发生有较好的预测价值,可为决策手术治疗提供依据。展开更多
目的探讨计数死亡率和发病率的生理学和手术严重性评分(physiological and operative sev- erity score for enumeration of mortality and morbidity,POSSUM)系统对大肠癌术后并发症及死亡发生率评估的价值。方法对143例大肠癌术前应用...目的探讨计数死亡率和发病率的生理学和手术严重性评分(physiological and operative sev- erity score for enumeration of mortality and morbidity,POSSUM)系统对大肠癌术后并发症及死亡发生率评估的价值。方法对143例大肠癌术前应用POSSUM评分系统进行评估;观察术后实际并发症和死亡发生率,并与预测值比较。结果手术侵袭度评分与大肠癌患者的存活率显著相关(P<0．05),预测并发症发生数为66人,实际发生数为43人,两者有显著性差异(P<0．05)。预测死亡数为12人,实际死亡数为7人,两者差异无统计学意义(P>0．05);在高危机组死亡发生率预测更具准确性(符合率100％),而在低危机组则高估其死亡发生率(符合率37．5％)。结论POSSUM评分系统能较好地预测大肠癌术后死亡发生率,并可影响术前选择术式。展开更多
文摘Background: The physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) is a scoring system previously validated in vascular and general surgical patients. The Portsmouth physiological and operative severity score for the enumeration of mortality and morbidity (P-POSSUM) is a reliable tool derived from POSSUM to improve the prediction of mortality. In this paper, we utilized both models to determine the most suitable and feasible one that could be utilized in orthopedic surgery in China mainland. Methods: In this retrospective study, patients’ files were extracted randomly from the medical records department of the First Hospital Affiliated with Dalian Medical University for those underwent hip replacements between 1999 and 2006. The mortality and morbidity rates were predicted by P-POSSUM and POSSUM, respectively. A comparative analysis was performed between the observed and the predicted values as well as the Observed/Expected ratio (O:E). Results: A total of 206 patients were selected for this study after fulfilling the inclusion and exclusion criteria. The predicted mortality by P-POSSUM were not significantly different from the observed values (X2 = 2.10, P = 0.552). POSSUM appeared to be better with the observed morbidity (X2 = 2.766, P = 0.598), but had overestimated mortality. Conclusion: The POSSUM morbidity equation satisfactorily estimated the risk of postoperative complications, and the P-POSSUM mortality equation appeared to stratify the risk of death more accurate than the POSSUM.
文摘背景与目的对于评价老年患者能否耐受肺癌手术,目前尚无明确标准。本研究旨在探讨改良POSSUM(Physiological and Operative Severity Score for the Umeration of Mortality and Morbidity)评分在预测老年非小细胞肺癌(non-small cell lung cancer,NSCLC)患者术后并发症发生率和病死率中的应用价值,为手术治疗的决策提供重要依据。方法 2007年12月-2013年12月在解放军总医院接受手术治疗的老年NSCLC患者138例,其中男性88例,女性50例,收集临床资料,各因素对术后实际并发症发生率和病死率的影响,采用二值多元Logistic回归分析。在有、无并发症两组中,采用成组t检验对标准及改良POSSUM评分值进行比较。绘制标准POSSUM和改良POSSUM的受试者工作特征曲线(receiver operating characteristic curve,ROC),计算曲线下面积(area under the curve,AUC),两组间AUC比较采用t检验。计算改良POSSUM评分预测值和实际并发症发生率和病死率的符合度。结果共有59例患者出现77例次术后并发症,手术死亡2例。Logistic回归分析,标准POSSUM的18项指标中17项及肺功能、肿瘤分期对术后并发症的发生有统计学意义(P<0.05),年龄对术后死亡有统计学意义(P<0.05)。在标准POSSUM评分中,并发症组与无并发症组的评分比较,差异有统计学意义(P<0.01)。在改良POSSUM评分中,并发症组与无并发症组的评分比较,差异有统计学意义(P<0.01)。改良POSSUM较标准POSSUM对术后并发症发生有更好的预测价值,两组AUC比较,差异有统计学意义(P<0.01)。但改良POSSUM对手术死亡的预测值过高。结论改良POSSUM评分对老年NSCLC术后并发症发生有较好的预测价值,可为决策手术治疗提供依据。
文摘目的探讨计数死亡率和发病率的生理学和手术严重性评分(physiological and operative sev- erity score for enumeration of mortality and morbidity,POSSUM)系统对大肠癌术后并发症及死亡发生率评估的价值。方法对143例大肠癌术前应用POSSUM评分系统进行评估;观察术后实际并发症和死亡发生率,并与预测值比较。结果手术侵袭度评分与大肠癌患者的存活率显著相关(P<0．05),预测并发症发生数为66人,实际发生数为43人,两者有显著性差异(P<0．05)。预测死亡数为12人,实际死亡数为7人,两者差异无统计学意义(P>0．05);在高危机组死亡发生率预测更具准确性(符合率100％),而在低危机组则高估其死亡发生率(符合率37．5％)。结论POSSUM评分系统能较好地预测大肠癌术后死亡发生率,并可影响术前选择术式。
