title: The possum scoring system and complete blood count in the prediction of complications after pancreato-duodenal area resections.
abstract: The introduction of markers which help in the identification of patients prone to suffer from postoperative complications enables to recognize them more easily and thus, treat them more effectively. THE AIM OF THE STUDY was to evaluate complete blood count indicators, as well as preoperative results obtained on the basis of the POSSUM and P-POSSUM scoring systems, considering the prediction of complications after surgical resections in the pancreato-duodenal area.
  
  
  METHODS
  A prospective 30-day non-interventional clinical study was conducted on a group of 65 patients who underwent scheduled surgery, due to pancreatic head cancer or chronic pancreatitis. Total pancreatoduodenectomy was performed in 24.1% of patients, while the remaining were subject to hemi-pancreatoduodenectomy. The authors evaluated the preoperative complete blood count parameters, as well as the risk of complications and mortality using the audit POSSUM and P-POSSUM scoring systems.
  
  
  RESULTS
  Postoperative complications were observed in 32.4% of patients. The white blood cell count and platelet count in the preoperative period were statistically lower in the group of patients with postoperative complications, in comparison to patients without diagnosed complications. Higher severity scores obtained by means of the P-POSSUM scoring system, as well as higher mortality during the perioperative period can be ascribed to patients who suffered postoperative complications. However, no correlation was found between the occurrence of complications and gender, age, type of resection, preoperative hemoglobin level, absolute lymphocyte count, or numerical value representing the patient's general condition (POSSUM) and predicted postoperative morbidity.
  
  
  CONCLUSIONS
  The absolute white blood cell count and total platelet count during the preoperative period may be considered as an indicator of the higher risk of complications during pancreato-duodenal area resections. The usefulness of the POSSUM and P-POSSUM scoring systems is limited. However, the surgical severity index and calculated mortality coefficient risk can facilitate the identification of patients threatened with postoperative complications.
authors.affiliation: Department of Surgery and Surgical Nursing, Medical University in Lublin.
authors.forename: Iwona
authors.initials: I
authors.lastname: Dębińska
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Smolińska
authors.forename: Jakub
authors.initials: J
authors.lastname: Osiniak
authors.forename: Piotr
authors.initials: P
authors.lastname: Paluszkiewicz
mesh_terms: D000328:Adult; D001772:Blood Cell Count; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000097:blood* / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000097:blood* / Q000209:etiology; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index