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Journal of Orthopaedic Surgery and Research

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Open Access 01-12-2022 | Systematic Review

Application of POSSUM and P-POSSUM scores in the risk assessment of elderly hip fracture surgery: systematic review and meta-analysis

Authors: Feng Wanjiang, Zhang Xiaobo, Wu Xin, Meng Ye, Huang Lihua, Wang Jianlong

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2022

Abstract

Background

Since Mohamed et al. analyzed 2326 orthopedic cases in 2002 and believed that the POSSUM formula can be directly used to predict postoperative morbidity and mortality in orthopedic patients, applications of POSSUM and P-POSSUM scores in the hip fracture surgery have been mostly reported in the field of orthopedics, but there are still some inconsistencies in the related reports.

Methods

The electronic library was searched for all literature that met the purpose from its inception to 2021. Relative risk (RR) was selected to evaluate whether the model could be used to assess the risk of surgery in patients with elderly hip fractures. Finally, sensitivity analyses and subgroup analyses were performed.

Results

Thirteen studies were finally included, including 9 retrospective and 4 prospective studies.The morbidity analysis includes 11 studies, and the result was RR = 1.07 (95% CI 0.93–1.24), The mortality analysis includes 11 studies on POSSUM and 5 studies on P-POSSUM. The results of mortality by POSSUM and by P-POSSUM were RR = 1.93 (95% CI 1.21–3.08) and RR = 1.15 (95% CI 0.89–1.50), respectively. POSSUM had more accuracy to predict mortality for sample < 200 subgroup(RR = 2.45; 95% CI 0.71–8.42) than sample > 200 subgroup(RR = 1.59; 95% CI 1.06–2.40), and in the subgroup of hip fractures that did not distinguish between specific fracture types(RR = 1.69, 95% CI 0.87–3.32) than intertrochanteric neck fracture subgroup(RR = 5.04, 95% CI 1.07–23.75) and femoral femoral fracture subgroup(RR = 1.43,95% CI 1.10–1.84).

Conclusion

POSSUM can be used to predict morbidity in elderly hip fractures. The P-POSSUM was more accurate in predicting mortality in elderly hip fracture patients compared to the POSSUM, whose predictive value for mortality was influenced by the sample size and type of fracture studied. In addition, we believe that appropriate improvements to the POSSUM system are needed to address the characteristics of orthopedic surgery.

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Title: Application of POSSUM and P-POSSUM scores in the risk assessment of elderly hip fracture surgery: systematic review and meta-analysis
Authors: Feng Wanjiang
Zhang Xiaobo
Wu Xin
Meng Ye
Huang Lihua
Wang Jianlong
Publication date: 01-12-2022
Publisher: BioMed Central
Published in: Journal of Orthopaedic Surgery and Research / Issue 1/2022
Electronic ISSN: 1749-799X
DOI: https://doi.org/10.1186/s13018-022-03134-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Application of POSSUM and P-POSSUM scores in the risk assessment of elderly hip fracture surgery: systematic review and meta-analysis

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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