A Systematic Review of POSSUM and its Related Models as Predictors of Post-operative Mortality and Morbidity in Patients Undergoing Surgery for Colorectal Cancer

Richards, C.H., Leitch, F.E., Horgan, P.G. and McMillan, D.C. (2010) A Systematic Review of POSSUM and its Related Models as Predictors of Post-operative Mortality and Morbidity in Patients Undergoing Surgery for Colorectal Cancer. Journal of Gastrointestinal Surgery, 14(10), pp. 1511-1519. (doi:10.1007/s11605-010-1333-5)

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Publisher's URL: http://dx.doi.org/10.1007/s11605-010-1333-5

Abstract

The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) model and its Portsmouth (P-POSSUM) and colorectal (CR-POSSUM) modifications are used extensively to predict and audit post-operative mortality and morbidity. This aim of this systematic review was to assess the predictive value of the POSSUM models in colorectal cancer surgery. Major electronic databases, including Medline, Embase, Cochrane Library and Pubmed were searched for original studies published between 1991 and 2010. Two independent reviewers assessed each study against inclusion and exclusion criteria. All data was specific to colorectal cancer surgery. Predictive value was assessed by calculating observed to expected (O/E) ratios. Nineteen studies were included in final review. The mortality analysis included ten studies (4,799 patients) on POSSUM, 17 studies (6,576 patients) on P-POSSUM and 14 studies (5,230 patients) on CR-POSSUM. Weighted O/E ratios for mortality were 0.31 (CI 0.31-0.32) for POSSUM, 0.90 (CI 0.88-0.92) for P-POSSUM and 0.64 (CI 0.63-0.65) for CR-POSSUM. The morbidity analysis included four studies (768 patients) on POSSUM with a weighted O/E ratio of 0.96 (CI 0.94-0.98). P-POSSUM was the most accurate model for predicting post-operative mortality after colorectal cancer surgery. The original POSSUM model was accurate in predicting post-operative complications.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Horgan, Professor Paul and McMillan, Professor Donald and Richards, Mr Colin
Authors: Richards, C.H., Leitch, F.E., 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:Journal of Gastrointestinal Surgery
ISSN:1091-255X

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