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Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 10/2010

01-10-2010 | 2010 SSAT Plenary Presentation

A Systematic Review of POSSUM and its Related Models as Predictors of Post-operative Mortality and Morbidity in Patients Undergoing Surgery for Colorectal Cancer

Authors: Colin Hewitt Richards, Fiona E. Leitch, Paul G. Horgan, Donald C. McMillan

Published in: Journal of Gastrointestinal Surgery | Issue 10/2010

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Abstract

Introduction

The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) model and its Portsmouth (P-POSSUM) and colorectal (CR-POSSUM) modifications are used extensively to predict and audit post-operative mortality and morbidity. This aim of this systematic review was to assess the predictive value of the POSSUM models in colorectal cancer surgery.

Methods

Major electronic databases, including Medline, Embase, Cochrane Library and Pubmed were searched for original studies published between 1991 and 2010. Two independent reviewers assessed each study against inclusion and exclusion criteria. All data was specific to colorectal cancer surgery. Predictive value was assessed by calculating observed to expected (O/E) ratios.

Results

Nineteen studies were included in final review. The mortality analysis included ten studies (4,799 patients) on POSSUM, 17 studies (6,576 patients) on P-POSSUM and 14 studies (5,230 patients) on CR-POSSUM. Weighted O/E ratios for mortality were 0.31 (CI 0.31–0.32) for POSSUM, 0.90 (CI 0.88–0.92) for P-POSSUM and 0.64 (CI 0.63–0.65) for CR-POSSUM. The morbidity analysis included four studies (768 patients) on POSSUM with a weighted O/E ratio of 0.96 (CI 0.94–0.98).

Conclusions

P-POSSUM was the most accurate model for predicting post-operative mortality after colorectal cancer surgery. The original POSSUM model was accurate in predicting post-operative complications.
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Metadata
Title
A Systematic Review of POSSUM and its Related Models as Predictors of Post-operative Mortality and Morbidity in Patients Undergoing Surgery for Colorectal Cancer
Authors
Colin Hewitt Richards
Fiona E. Leitch
Paul G. Horgan
Donald C. McMillan
Publication date
01-10-2010
Publisher
Springer-Verlag
Published in
Journal of Gastrointestinal Surgery / Issue 10/2010
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-010-1333-5

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