Modified physiological and operative score for the enumeration of mortality and morbidity risk assessment model in general surgery.
OBJECTIVE
To establish a scoring system for predicting the incidence of postoperative complications and mortality in general surgery based on the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM), and to evaluate its efficacy.


METHODS
Eighty-four patients with postoperative complications or death and 172 patients without postoperative complications, who underwent surgery in our department during the previous 2 years, were retrospectively analyzed by logistic regression. Fifteen indexes were investigated including age, cardiovascular function, respiratory function, blood test results, endocrine function, central nervous system function, hepatic function, renal function, nutritional status, extent of operative trauma, and course of anesthesia. Modified POSSUM (M-POSSUM) was developed using significant risk factors with its efficacy evaluated.


RESULTS
The significant risk factors were found to be age, cardiovascular function, respiratory function, hepatic function, renal function, blood test results, endocrine function, nutritional status, duration of operation, intraoperative blood loss, and course of anesthesia. These factors were all included in the scoring system. There were significant differences in the scores between the patients with and without postoperative complications, between the patients died and survived with complications, and between the patients died and survived without complications. The receiver operating characteristic curves showed that the M-POSSUM could accurately predict postoperative complications and mortality.


CONCLUSIONS
M-POSSUM correlates well with postoperative complications and mortality, and is more accurate than POSSUM.
Ding
Lian-An
LA
Department of General Surgery, Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, Shandong Province, China. dlahaolq@gmail.com
Sun
Li-Qun
LQ
Chen
Shuang-Xi
SX
Qu
Lin-Lin
LL
Xie
Dong-Fang
DF
D006305:Health Status Indicators; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology; D016015:Logistic Models; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology; D011237:Predictive Value of Tests; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors