title: Usefulness of POSSUM physiological score for the estimation of morbidity and mortality risk after elective abdominal aortic aneurysm repair in Japan.
abstract: BACKGROUND
  The Physiological and Operative Severity Score for enUmeration of Mortality and morbidity (POSSUM), which consists of a physiological score (PS) and an operative severity score, is useful in determining the risk profile for patients with abdominal aortic aneurysms in Western countries, but no information is available on the use of this method in Japan.
  
  
  RESULTS
  A retrospective cohort study involving 225 patients was performed, and the prognostic factors for morbidity and in-hospital mortality including POSSUM were investigated. The morbidity rate was 26%. On univariate analysis age, renal disease, hemoglobin, albumin, operation time, blood loss and PS were significantly different. On multivariate analysis PS was significantly different. Using receiver operating characteristic (ROC) analysis, PS had an area under the curve (AUC) of 0.712 and the best cut-off point was 18. The in-hospital mortality rate was 2.2%. On univariate analysis renal disease, albumin and PS were significantly different, and on multivariate analysis PS was significantly different. On ROC analysis PS had an AUC of 0.921 and the best cut-off point was 22.
  
  
  CONCLUSIONS
  PS was the only independent risk factor for morbidity and in-hospital mortality. Further studies may be required to develop a risk-scoring system.
authors.affiliation: Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan. akodama@med.nagoya-u.ac.jp
authors.forename: Akio
authors.initials: A
authors.lastname: Kodama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Narita
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Kimihiro
authors.initials: K
authors.lastname: Komori
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000453:epidemiology / Q000401:mortality* / Q000601:surgery*; D015331:Cohort Studies; D017558:Elective Surgical Procedures / Q000379:methods*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index