Surgery: Current Research

Surgery: Current Research
Open Access

ISSN: 2161-1076


P-POSSUM over-predicts morbidity in patients undergoing open liver resection

2nd International Conference on Surgery and Anesthesia

September 16-18, 2013 Hampton Inn Tropicana, Las Vegas, NV, USA

Rassam Ziyad

Posters: Surgery Curr Res

Abstract :

Introduction: A study by Whiteley et al in 1998 suggested that the Physiological and Operative Severity Score for the enumeration of Morbidity and Mortality (POSSUM) over-predicted mortality (especially in low risk patients). This led to the development of (Portsmouth - POSSUM) scoring system in an attempt to counteract this. The last 20 years have seen significant advances in surgical techniques and perioperative management leading to a reduction in morbidity and mortality for many different surgical specialties. We examined the use of P-POSSUM scoring to predict outcomes in patients undergoing elective liver resection surgery at our centre. Method: P-POSSUM scores and mortality and morbidity figures were collected for 92 patients as part of a larger trial. SPatients were allocated to 5 different morbidity risks.ZThe number of patients predicted to suffer postoperative morbidity/mortality in each group was compared with the actual number of patients observed to have postoperative morbidity/mortality. Results: P-POSSUM significantly over-predicted the total number of patients that would suffer postoperative morbidity (50 versus 22 patients who actually suffered morbidity, p<0.001). P-POSSUM was more accurate in predicting morbidity in lower risk patients than higher risk patients, where it significantly over-predicted morbidity in both the 40-59% and 60-79% risk groups (p=0.032 and p=0.001 respectively).Overall mortality was accurately predicted by P-POSSUM (four versus two patients who actually died, p=0.6826). Conclusion: P-POSSUM appears to be good at predicting mortality but over-predicts morbidity in open liver resection.

Biography :

Rassam Ziyad has completed his Primary medical degree from Al-Mustansiriya University, 1993 and postdoctoral studies from Baghdad University School of Medicine, 1996. He is a Fellow of the Royal College of Anesthetists, England, 2009. He has served a year as a clinical and research follow in anesthesia for high risk surgery at Royal Surrey County Hospital in Guildford, UK.