title: Significance of the POSSUM scoring system in predicting morbidity and mortality in elderly patients after pancreatoduodenectomy.
abstract: OBJECTIVE
  To explore the significance of POSSUM scoring system (Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity) in predicting morbidity and mortality in elderly Chinese patients undergoing pancreatoduodenectomy (PD).
  
  
  METHODS
  Between January 2001 and January 2011, 396 patients underwent PD in our hospital; POSSUM and P-POSSUM score were retrospectively calculated for each patient and correlated with observed morbidity and mortality, respectively.
  
  
  RESULTS
  The mortality and morbidity rates were 4.11% and 42.8%, respectively. The POSSUM showed “good fit” in morbidity prediction (p=0.103), it also showed “good fit” in mortality prediction but only in elderly patients (p=0.078). While in young patients, POSSUM showed “poor fit” in both morbidity (p=0.002) and mortality (p=0.012) prediction.
  
  
  CONCLUSIONS
  The POSSUM showed significance in predicting morbidity and mortality in elderly Chinese patients, and is helpful in guiding surgical management decisions. A modified equation for POSSUM scoring system based on large-scale clinical PD data should be developed to achieve a better fit in low-risk patients.
authors.forename: Jingtao
authors.initials: J
authors.lastname: Zhong
authors.forename: Lei
authors.initials: L
authors.lastname: Zhao
authors.forename: Wuyuan
authors.initials: W
authors.lastname: Zhou
authors.forename: Lei
authors.initials: L
authors.lastname: Li
authors.forename: Xuetao
authors.initials: X
authors.lastname: Shi
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000401:mortality*; D012189:Retrospective Studies; D012720:Severity of Illness Index