POSSUM and P-POSSUM overpredict mortality for carotid endarterectomy

European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery
G KuhanP T McCollum

Abstract

the aim was to test the predictive accuracy of POSSUM and P-POSSUM on patients undergoing CEA. retrospective and prospective study. 499 CEAs performed by four vascular surgeons from a single unit from 1992-99. The median age was 68 (range 38-86) and 60% were men. physiological parameters, operative parameters and the 30-day mortality were collected. Predicted mortality for each patient was calculated using POSSUM and P-POSSUM equations. Patients were stratified into risk groups and observed and predicted deaths were compared. Accuracy of the prediction was assessed using chi-squared analysis. the observed 30-day mortality was 1.8% (9/499). The predicted deaths using POSSUM and P-POSSUM analysis were 49 and 25 respectively compared to nine observed deaths. There was significant evidence of lack of fit of both models in predicting mortality (chi-squared analysis, p<0.05). POSSUM and P-POSSUM overpredict mortality and are unsuitable for comparative audit of CEA. Models developed specific for CEA might accurately predict mortality.

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Citations

Apr 23, 2009·World Journal of Surgery·S M M de CastroD J Gouma
Mar 13, 2010·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·W ChenN W Knuckey
Jun 8, 2006·Current Surgery·Seetharaman Hariharan, Andrew Zbar
Oct 12, 2007·Journal of Vascular Surgery·Andrew L TambyrajaRoderick T A Chalmers
Feb 9, 2018·Langenbeck's Archives of Surgery·Sudharsan MadhavanSameer P Junnarkar
Mar 1, 2005·The British Journal of Surgery·H LloydJ R S Blake
Oct 12, 2007·The British Journal of Surgery·S M LagardeJ J B van Lanschot
Aug 27, 2009·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·G UgoliniM Taffurelli
Mar 30, 2004·The British Journal of Surgery·C-M LamK Poon

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