POSSUM and its related models as predictors of postoperative mortality and morbidity in patients undergoing surgery for gastro-oesophageal cancer: a systematic review

Dutta, S., Horgan, P.G. and McMillan, D.C. (2010) POSSUM and its related models as predictors of postoperative mortality and morbidity in patients undergoing surgery for gastro-oesophageal cancer: a systematic review. World Journal of Surgery, 34(9), pp. 2076-2082. (doi:10.1007/s00268-010-0685-z)

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Publisher's URL: http://dx.doi.org/10.1007/s00268-010-0685-z

Abstract

<p><b>Background</b></p> <p>Gastro-oesophageal surgery is associated with appreciable postoperative morbidity and mortality. POSSUM (Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity) and its related models P-POSSUM and O-POSSUM have been developed to predict such events in general surgery. The aim was to undertake the first systematic review of the use of these models in gastro-oesophageal surgery patients.</p> <p><b>Methods</b></p> <p>An online database search was carried out from 1991 to December 2008.</p> <p><b>Results</b></p> <p>Twenty-two published studies in gastro-oesophageal cancer surgery were identified. Twelve studies were found not to address the above aim, leaving ten relevant publications for analysis. Pooled data from these studies showed the weighted observed-to-expected ratio (O/E) for postoperative mortality using POSSUM (n = 1189), P-POSSUM (n = 2314), and O-POSSUM (n = 1755) was 0.37, 0.83, and 0.51, respectively. The weighted O/E for morbidity using POSSUM (n = 1038) was 0.86.</p> <p><b>Conclusion</b></p> <p>POSSUM and O-POSSUM most significantly overestimated postoperative mortality in gastro-oesophageal cancer patients. In contrast, P-POSSUM had the least overestimation and may be the most useful predictor of likely postoperative mortality in these patients. Part of this work was presented as posters at The Annual Scientific Meeting of the Association of Surgeons of Great Britain and Ireland, Glasgow 2009, and abstracts have been published in British Journal of Surgery 2009; 96(S4).</p>

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Dutta, Mr Sumanta and Horgan, Professor Paul and McMillan, Professor Donald
Authors: Dutta, S., Horgan, P.G., and McMillan, D.C.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
Journal Name:World Journal of Surgery
Publisher:Springer
ISSN:0364-2313
Published Online:17 June 2010

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