Morbimortality assessment in abdominal surgery: are we predicting or overreacting?
Abstract Background High-risk surgical procedures represent a fundamental part of general surgery practice due to its significant rates of morbidity and mortality. Different predictive tools have been created in order to quantify perioperative morbidity and mortality risk. POSSUM (Physiological and...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-01-01
|
| Series: | BMC Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12893-021-01455-1 |
| _version_ | 1798016355050455040 |
|---|---|
| author | Sebastian Valenzuela Laura Niño Danny Conde Felipe Girón Lina Rodríguez David Venegas Carlos Rey Ricardo Nassar Marco Vanegas Daniel Jiménez |
| author_facet | Sebastian Valenzuela Laura Niño Danny Conde Felipe Girón Lina Rodríguez David Venegas Carlos Rey Ricardo Nassar Marco Vanegas Daniel Jiménez |
| author_sort | Sebastian Valenzuela |
| collection | DOAJ |
| description | Abstract Background High-risk surgical procedures represent a fundamental part of general surgery practice due to its significant rates of morbidity and mortality. Different predictive tools have been created in order to quantify perioperative morbidity and mortality risk. POSSUM (Physiological and Operative Severity Score for the enumeration of Mortality and morbidity) is one of the most widely validated predictive scores considering physiological and operative variables to precisely define morbimortality risk. Nevertheless, seeking greater accuracy in predictions P-POSSUM was proposed. We aimed to compare POSSUM and P-POSSUM for patients undergoing abdominal surgery. Methods A retrospective observational study with a prospective database was conducted. Patients over 18 years old who complied with inclusion criteria between 2015 and 2016 were included. Variables included in the POSSUM and P-POSSUM Scores were analyzed. Descriptive statistics of all study parameters were provided. The analysis included socio-demographic data, laboratory values , and imaging. Bivariate analysis was performed. Results 350 Patients were included in the analysis, 55.1% were female. The mean age was 55.9 ± 20.4 years old. POSSUM revealed a moderated index score in 61.7% of the patients, mean score of 12.85 points ± 5.61. 89.1% of patients had no neoplastic diagnosis associated. Overall morbidity and mortality rate was 14.2% and 7.1%. P-POSSUM could predict more precisely mortality (p < 0.00). Conclusions The POSSUM score is likely to overestimate the risk of morbidity and mortality in patients with high/moderate risk, while the P-POSSUM score seems to be a more accurate predictor of mortality risk. Further studies are needed to confirm our results. |
| first_indexed | 2024-04-11T15:49:20Z |
| format | Article |
| id | doaj.art-9d6371ace5c54c15954518c250d2b1f7 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-04-11T15:49:20Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-9d6371ace5c54c15954518c250d2b1f72022-12-22T04:15:26ZengBMCBMC Surgery1471-24822022-01-012211610.1186/s12893-021-01455-1Morbimortality assessment in abdominal surgery: are we predicting or overreacting?Sebastian Valenzuela0Laura Niño1Danny Conde2Felipe Girón3Lina Rodríguez4David Venegas5Carlos Rey6Ricardo Nassar7Marco Vanegas8Daniel Jiménez9Department of Surgery, Hospital Universitario MederiSchool of Medicine, Universidad del RosarioDepartment of Surgery, Hospital Universitario MederiDepartment of Surgery, Hospital Universitario MederiSchool of Medicine, Universidad de los AndesDepartment of Surgery, Hospital Universitario MederiDepartment of Surgery, Hospital Universitario MederiSchool of Medicine, Universidad del RosarioDepartment of Surgery, Hospital Universitario MederiSchool of Medicine, Universidad del RosarioAbstract Background High-risk surgical procedures represent a fundamental part of general surgery practice due to its significant rates of morbidity and mortality. Different predictive tools have been created in order to quantify perioperative morbidity and mortality risk. POSSUM (Physiological and Operative Severity Score for the enumeration of Mortality and morbidity) is one of the most widely validated predictive scores considering physiological and operative variables to precisely define morbimortality risk. Nevertheless, seeking greater accuracy in predictions P-POSSUM was proposed. We aimed to compare POSSUM and P-POSSUM for patients undergoing abdominal surgery. Methods A retrospective observational study with a prospective database was conducted. Patients over 18 years old who complied with inclusion criteria between 2015 and 2016 were included. Variables included in the POSSUM and P-POSSUM Scores were analyzed. Descriptive statistics of all study parameters were provided. The analysis included socio-demographic data, laboratory values , and imaging. Bivariate analysis was performed. Results 350 Patients were included in the analysis, 55.1% were female. The mean age was 55.9 ± 20.4 years old. POSSUM revealed a moderated index score in 61.7% of the patients, mean score of 12.85 points ± 5.61. 89.1% of patients had no neoplastic diagnosis associated. Overall morbidity and mortality rate was 14.2% and 7.1%. P-POSSUM could predict more precisely mortality (p < 0.00). Conclusions The POSSUM score is likely to overestimate the risk of morbidity and mortality in patients with high/moderate risk, while the P-POSSUM score seems to be a more accurate predictor of mortality risk. Further studies are needed to confirm our results.https://doi.org/10.1186/s12893-021-01455-1Risk prediction modelMortalityCritical careLaparotomyPrognosis |
| spellingShingle | Sebastian Valenzuela Laura Niño Danny Conde Felipe Girón Lina Rodríguez David Venegas Carlos Rey Ricardo Nassar Marco Vanegas Daniel Jiménez Morbimortality assessment in abdominal surgery: are we predicting or overreacting? BMC Surgery Risk prediction model Mortality Critical care Laparotomy Prognosis |
| title | Morbimortality assessment in abdominal surgery: are we predicting or overreacting? |
| title_full | Morbimortality assessment in abdominal surgery: are we predicting or overreacting? |
| title_fullStr | Morbimortality assessment in abdominal surgery: are we predicting or overreacting? |
| title_full_unstemmed | Morbimortality assessment in abdominal surgery: are we predicting or overreacting? |
| title_short | Morbimortality assessment in abdominal surgery: are we predicting or overreacting? |
| title_sort | morbimortality assessment in abdominal surgery are we predicting or overreacting |
| topic | Risk prediction model Mortality Critical care Laparotomy Prognosis |
| url | https://doi.org/10.1186/s12893-021-01455-1 |
| work_keys_str_mv | AT sebastianvalenzuela morbimortalityassessmentinabdominalsurgeryarewepredictingoroverreacting AT lauranino morbimortalityassessmentinabdominalsurgeryarewepredictingoroverreacting AT dannyconde morbimortalityassessmentinabdominalsurgeryarewepredictingoroverreacting AT felipegiron morbimortalityassessmentinabdominalsurgeryarewepredictingoroverreacting AT linarodriguez morbimortalityassessmentinabdominalsurgeryarewepredictingoroverreacting AT davidvenegas morbimortalityassessmentinabdominalsurgeryarewepredictingoroverreacting AT carlosrey morbimortalityassessmentinabdominalsurgeryarewepredictingoroverreacting AT ricardonassar morbimortalityassessmentinabdominalsurgeryarewepredictingoroverreacting AT marcovanegas morbimortalityassessmentinabdominalsurgeryarewepredictingoroverreacting AT danieljimenez morbimortalityassessmentinabdominalsurgeryarewepredictingoroverreacting |