title: [The POSSUM: a good scoring system for predicting mortality in elderly patients undergoing emergency surgery?]
abstract: BACKGROUND
  POSSUM (Physiologic and Operative Severity Score for the enumeration of Mortality and morbidity) is a scoring system for predicting mortality which is largely used in elective aortic and abdominal surgery. The aim of our study was to validate POSSUM with regards to elderly patients (> 70 years) undergoing digestive emergency surgery. We wanted to determine the optimal threshold for POSSUM, consisting of a physiological score and of an operative score for predicting mortality in this population.
  
  
  METHODS
  This is a case-control analytic retrospective study of 291 patients aged ≥70 years undergoing digestive emergency surgery. These patients were divided into two groups each comprising 50 patients. Group "DC": patients died in the immediate postoperative period and Control group "SURV" chosen by lot. We analyzed the reliability of POSSUM in predicting mortality and morbidity. Subsequently, we created ROC curve to find the thresholds with the best sensitivity/specificity couple.
  
  
  RESULTS
  The physiological score, operative score and mortality and morbidity rates predicted by POSSUM and mortality predicted by P-POSSUM are predictors of mortality (P < 0.0001). The threshold values for the physiological and operative score with the best sensitivity/specificity couple were 23 and 15 respectively.
  
  
  CONCLUSIONS
  Predicting mortality in patients allows to target care management programs and to inform the patient and his family of the risks.
authors: Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie; Service de Chirurgie Viscérale CHU Mongi Slim, Sidi Daoued La Marsa, Tunisie.
authors: Zeineb
authors: Z
authors: Mzoughi
authors: Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie; Service de Chirurgie Viscérale CHU Mongi Slim, Sidi Daoued La Marsa, Tunisie.
authors: Rached
authors: R
authors: Bayar
authors: Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie; Service de Chirurgie Viscérale CHU Mongi Slim, Sidi Daoued La Marsa, Tunisie.
authors: Achref
authors: A
authors: Djebbi
authors: Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie; Service de Chirurgie Viscérale CHU Mongi Slim, Sidi Daoued La Marsa, Tunisie.
authors: Ghofrane
authors: G
authors: Talbi
authors: Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie; Service de Gastroentérologie CHU Mongi Slim, Sidi Daoued La Marsa, Tunisie.
authors: Hayfa
authors: H
authors: Romdhane
authors: Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie; Service de Gastroentérologie CHU Mongi Slim, Sidi Daoued La Marsa, Tunisie.
authors: Wafa
authors: W
authors: Aloui
authors: Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie; Service de Chirurgie Viscérale CHU Mongi Slim, Sidi Daoued La Marsa, Tunisie.
authors: Gharbi
authors: G
authors: Lassaad
authors: Université de Tunis El Manar, Faculté de Médecine de Tunis, 1007, Tunis, Tunisie; Service de Chirurgie Viscérale CHU Mongi Slim, Sidi Daoued La Marsa, Tunisie.
authors: Mohamed Taher
authors: MT
authors: Khalfallah
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D013505:Digestive System Surgical Procedures / Q000401:mortality*; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000401:mortality; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: POSSUM; elderly; emergency; mortality; score; surgery