[The POSSUM scoring system for risks assessment in pancreatoduodenectomy].
OBJECTIVE
To explore the value of the POSSUM scoring system in predicting postoperative morbidity and mortality of pancreatoduodenectomy (PD).


METHODS
Two hundreds and sixty-five consecutive PDs were performed between January 2005 and December 2007. POSSUM scores which relied on 12 physiologic and 6 operative variables were prospectively calculated for each case. Expected morbidity and mortality were estimated based on POSSUM scores and were compared with observed morbidity, which were diagnosed according to the Clavien complication scheme and domestic reference criteria respectively, and mortality.


RESULTS
Physiologic scores of 265 cases ranged from 12 to 24,the mean was 15. Operative scores ranged from 14 to 24, the mean was 17. The overall POSSUM scores ranged from 0.24 to 0.88. Average expected morbidity was 43.8%, expected cases were 116. Observed morbidity rate was 39.6% (105/265). The expected and observed morbidities and cases had no significantly differences. All patients were classified to 1 of 4 strata based on their individual POSSUM scores and subsequent risk of morbidity. Predictive value was the highest when scores ranged from 0.4 to 0.8. POSSUM exhibited less predictive value for mortality, but if POSSUM was more than 0.5, it was useful for mortality predicting.


CONCLUSIONS
POSSUM scoring system has high value for predicting the risk of morbidity in PD and can be helpful in guiding surgery and postoperative management decisions.
Tian
Bo-Le
BL
Department of Hepato-bilio-pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China. bo-le@medmail.com.cn
Zhang
Zhao-Da
ZD
Liu
Xu-Bao
XB
Hu
Wei-Ming
WM
Mai
Gang
G
Zeng
Yong
Y
Li
Zhen-Jun
ZJ
Zhang
Yi
Y
Le
Xin-Hui
XH
Lu
Hui-Min
HM
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000401:mortality; D011183:Postoperative Complications; D011446:Prospective Studies; D018570:Risk Assessment