Document Detail

Comparison of POSSUM and the Portsmouth predictor equation for predicting death following vascular surgery.
MedLine Citation:
PMID:  9501818     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The Physiological and Operative Severity Score for enUmeration of Mortality and morbidity (POSSUM) scoring system has been proposed as an accurate predictor of death which takes account of case mix. It appears to overpredict death, and may have drawbacks which prevent accurate individual or subgroup analysis. An alternative system, the Portsmouth predictor equation for mortality (P-POSSUM) may have overcome these problems, but its apparent advantage could be related to inappropriate analysis of POSSUM predictions. METHODS: Some 312 patients having arterial procedures were studied. POSSUM and P-POSSUM scores were used to predict death and compared with actual outcomes. The observed:predicted (O:E) mortality ratios were calculated by two methods for each of the scoring systems. First the analysis devised by the inventors of POSSUM was used and second the method devised for P-POSSUM. RESULTS: The O:E ratio for POSSUM using its recommended 'exponential' method of analysis was 1.14, but it was 0.59 if the P-POSSUM 'linear' analysis was used. The O:E ratio for P-POSSUM using its correct method of analysis was 0.89, but it was 0.67 if the method of analysis devised for POSSUM was used. CONCLUSION: The O:E ratios for POSSUM and P-POSSUM were close to unity when the appropriate analysis was performed. Both POSSUM and P-POSSUM overpredicted death if the incorrect analysis was used.
L D Wijesinghe; T Mahmood; D J Scott; D C Berridge; P J Kent; R C Kester
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The British journal of surgery     Volume:  85     ISSN:  0007-1323     ISO Abbreviation:  Br J Surg     Publication Date:  1998 Feb 
Date Detail:
Created Date:  1998-03-26     Completed Date:  1998-03-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  209-12     Citation Subset:  AIM; IM    
Department of Vascular and Endovascular Surgery, St James's University Hospital, Leeds, UK.
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MeSH Terms
Aged, 80 and over
Postoperative Period
Risk Assessment
Risk Factors
Severity of Illness Index*
Vascular Diseases / mortality*,  surgery
Vascular Surgical Procedures / mortality*
Comment In:
Br J Surg. 1999 May;86(5):713-4   [PMID:  10361356 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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