Published in:
Open Access
01-12-2015 | Research article
Risk assessment and decision-making for patients undergoing orthopedic surgery
Authors:
De-ming Bao, Ning Li, Lei Xia
Published in:
Journal of Orthopaedic Surgery and Research
|
Issue 1/2015
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Abstract
Purpose
Physical and operative severity score for the enumeration of mortality and morbidity (POSSUM) scoring system was designed to predict the postoperative morbidity and mortality mainly in general surgery. The purpose of this study was to assess the value of POSSUM scoring system in predicting outcomes of patients undergoing orthopedic surgery, and to do some modifications to make the system more accurate in predicting postoperative complication rates.
Methods
This is a retrospective clinical study involving 779 patients between April 1, 2009 and September 1, 2010. The postoperative complication rates were predicted by POSSUM, and then compared with the actual morbidity. Logistic regression was taken to improve the POSSUM equation.
Results
In the 779 cases, the predicted morbidity was 27.2 % (212 cases) by POSSUM, while the actual morbidity is 8.3 % (65 cases).
Conclusion
POSSUM excessively predicted the morbidity of patients undergoing orthopedic surgery, and it could be more accurate with appropriate modification. Of all risk factors, echocardiography ejection fraction showed a close relationship with postoperative complications.