Application of Portsmouth modification of physiological and operative severity scoring system for enumeration of morbidity and mortality (P-POSSUM) in pancreatic surgery.

World Journal of Surgical Oncology
Appou TamijmaraneJohn Ac Buckels

Abstract

Pancreatoduodenectomy (PD) is associated with high incidence of morbidity and mortality. We have applied P-POSSUM in predicting the incidence of outcome after PD to identify those who are at the highest risk of developing complications. A prospective database of 241 consecutive patients who had PD from January 2002 to September 2005 was retrospectively updated and analysed. P-POSSUM score was calculated for each patient and correlated with observed morbidity and mortality. 30 days mortality was 7.8% and morbidity was 44.8%. Mean physiological score was 16.07 +/- 3.30. Mean operative score was 13.67 +/- 3.42. Mean operative score rose to 20.28 +/- 2.52 for the complex major operation (p < 0.001) with 2 fold increase in morbidity and 3.5 fold increase in mortality. For groups of patients with a physiological score of (less than or equal to) 18, the O:P (observed to Predicted) morbidity ratio was 1.3-1.4 and, with a physiological score of >18, the O:P ratio was nearer to 1. Physiological score and white cell count were significant in a multivariate model. P-POSSUM underestimated the mortality rate. While P-POSSUM analysis gave a truer prediction of morbidity, underestimation of morbidity and potential for systematic inaccuracy in ...Continue Reading

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Citations

Jun 24, 2010·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Charbel SandroussiAlice C Wei
Apr 23, 2009·World Journal of Surgery·S M M de CastroD J Gouma
Jul 17, 2014·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Felix RückertRobert Grützmann
Mar 6, 2013·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Vishnu V ChandrabalanEuan J Dickson
Jul 16, 2010·The British Journal of Oral & Maxillofacial Surgery·David Francis Tighe
Jul 26, 2012·The British Journal of Surgery·F AusaniaR M Charnley
Mar 18, 2015·Acta Anaesthesiologica Scandinavica·C ChelazziA R De Gaudio
Feb 11, 2014·Journal of Cardiothoracic and Vascular Anesthesia·Balachundhar SubramaniamMadalena D Costa
Feb 12, 2010·The Journal of International Medical Research·Y ZhangB-L Tian
Apr 9, 2009·The American Journal of Gastroenterology·Kanwar Rupinder S GillMassimo Raimondo
Nov 2, 2011·Annals of Surgery·Marco BragaValerio Di Carlo
Jun 11, 2009·Current Opinion in Critical Care·S Ramani MoonesingheMichael P W Grocott
May 25, 2010·Anesthesia and Analgesia·Suneetha Ramani MoonesingheMichael Patrick William Grocott
Mar 21, 2009·Annals of Surgery·Robert W EppsteinerShimul A Shah
Nov 8, 2012·Annals of the Royal College of Surgeons of England·F AusaniaB C Jaques
Jul 27, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Francisco Igor B MacedoNipun Merchant

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Methods Mentioned

BETA
pancreatectomy

Software Mentioned

POSSUM
POSSUM ( Scoring System Enumeration
Statistical Package for the Social Sciences

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