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首页> 外文期刊>Clinical Interventions in Aging >Application of POSSUM and P-POSSUM in Surgical Risk Assessment of Elderly Patients Undergoing Hepatobiliary and Pancreatic Surgery
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Application of POSSUM and P-POSSUM in Surgical Risk Assessment of Elderly Patients Undergoing Hepatobiliary and Pancreatic Surgery

机译：Possum和p-possum在肝胆和胰腺手术中老年患者外科风险评估中的应用

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Purpose: To investigate the efficacy and accuracy of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) and Portsmouth-POSSUM (P-POSSUM) scoring systems in the risk assessment of postoperative complications and death in elderly patients undergoing hepatobiliary and pancreatic surgery. Patients and Methods: Using POSSUM and P-POSSUM, 274 elderly patients undergoing hepatobiliary and pancreatic surgery were evaluated, and the complications and deaths predicted by the systems were compared with the actual situation. The accuracy and predictive ability of POSSUM and P-POSSUM were evaluated using chi-squared and t -tests, consistency of predicted and actual complication rates (observed/expected, OE ratio), and receiver operating characteristic (ROC) curve. Results: The complication rate predicted by POSSUM (R1) was 22.57%, while the actual postoperative complication rate was 17.88% (P 0.05). The mortality rate predicted by POSSUM (R2) was 4.61%, while the actual rate was 1.09% (P 0.05). The mortality rate predicted by P-POSSUM (R) was 1.42%, while the actual rate was 1.09% (P 0.05). Patients with complications had higher physiology scores (PS), operative severity scores (OS), and POSSUM scores than those without complications (P 0.05). Furthermore, PS, OS, and POSSUM scores were higher in the mortality group than in the survival group. However, the number of individuals in the mortality group was too small to accurately reflect the overall situation. Stratified analysis showed that consistency of the OE ratio in different subgroups was close to 1. The ROC curve showed that the area under the curve for the complication rate predicted by POSSUM was 0.76. Conclusion: Although the postoperative mortality rate was higher than the actual value, POSSUM could accurately predict the postoperative complication rate in elderly patients undergoing hepatobiliary and pancreatic surgery. The P-POSSUM accurately predicted the postoperative mortality rate in this population. Patients with complications had higher POSSUM scores.
机译：目的：探讨生理和手术严重程度的疗效和准确性，以枚举死亡率和发病率（POSSUM）和疏远小道患者术后术后并发症和死亡的疏松症患者的疏松症患者的疏松症患者和胰腺手术。患者和方法：使用负鼠和p-possum，评估了274名后患者进行肝胆和胰腺手术的患者，并将系统预测的并发症和死亡与实际情况进行了比较。使用Chi方向和T -Tests，预测和实际并发症率（观察到/预期，OE比率）和接收器操作特征（ROC）曲线的阶段评估负极和P-possum的精度和预测能力。结果：Possum（R1）预测的并发症率为22.57％，而实际术后并发症率为17.88％（P> 0.05）。 Possum（R2）预测的死亡率为4.61％，而实际速率为1.09％（P <0.05）。 P-Possum（R）预测的死亡率为1.42％，实际速率为1.09％（P> 0.05）。并发症的患者具有较高的生理分数（PS），手术严重分数（OS），以及比没有并发症的药物分数（P <0.05）。此外，PS，OS和POSTUM分数在死亡率组中比存活组更高。但是，死亡组中的个体数量太小，无法准确反映整体情况。分层分析表明，不同亚组中的OE比的一致性接近1.ROC曲线表明，负载率预测的并发症率下的曲线下的面积为0.76。结论：虽然术后死亡率高于实际值，但可能可以准确地预测经过肝胆和胰腺手术的老年患者的术后并发症率。 P-Possum准确地预测了该人群的术后死亡率。患有并发症的患者具有较高的负鼠得分。

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