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International Journal of Colorectal Disease

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01-12-2009 | Original Article

Predicting post-operative mortality in patients undergoing colorectal surgery using P-POSSUM and CR-POSSUM scores: a prospective study

Authors: Edmund Leung, Ali M. Ferjani, Nigel Stellard, Ling S. Wong

Published in: International Journal of Colorectal Disease | Issue 12/2009

Abstract

Introduction

POSSUM and its variants Portsmouth POSSUM (P-POSSUM) and Colorectal POSSUM (CR-POSSUM) equations were derived from a heterogeneous general surgical population, which have been used successfully to provide risk-adjusted operative mortality rates. CR-POSSUM utilises fewer parameters, allowing ease of use. The aim of this study was to predict the mortality outcome in colorectal surgery using these scoring systems compared to the observed mortality and to devise a new scoring system with improved accuracy.

Methods

The study was conducted prospectively on all consecutive patients requiring elective and emergency colorectal surgery between April 2002 and May 2005. The outcome parameter was defined as 30-day mortality. The observed mortality was compared with predicted mortality by the scoring systems. Hosmer and Lemeshow test was used to assess statistical accuracy of POSSUM.

Results

Eight hundred ninety-nine patients underwent colorectal surgery during the study period. There were 619 elective and 281 emergency patients. Observed 30-day mortality rate was 9%, compared with predicted mortality rate of 13.5% with POSSUM, 5% with P-POSSUM and 9.5% with CR-POSSUM.

Conclusion

POSSUM’s mortality rate was overestimated, while P-POSSUM’s mortality rate was underestimated. CR-POSSUM, the simplest system of all three, most accurately predicted mortality in our unit.

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Title: Predicting post-operative mortality in patients undergoing colorectal surgery using P-POSSUM and CR-POSSUM scores: a prospective study
Authors: Edmund Leung
Ali M. Ferjani
Nigel Stellard
Ling S. Wong
Publication date: 01-12-2009
Publisher: Springer-Verlag
Published in: International Journal of Colorectal Disease / Issue 12/2009
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-009-0781-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Predicting post-operative mortality in patients undergoing colorectal surgery using P-POSSUM and CR-POSSUM scores: a prospective study

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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