Risk Assessments for Elderly Patients with Hip Arthro-plasty Using POSSUM and P-POSSUM

Yuancheng Li, Hassan H. Dib, Weiguo Zhang, Xiao Zhang

Department of Orthopedic Surgery, First Affiliated Hospital of Dalian Medical University, Dalian, China.
Department of Radiology, Dalian Central Hospital, Dalian, China..
Medicose Health Net Inc., Richmond Hill, Canada..

DOI: 10.4236/ojo.2013.32011                

Abstract

Background: The physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) is a scoring system previously validated in vascular and general surgical patients. The Portsmouth physiological and operative severity score for the enumeration of mortality and morbidity (P-POSSUM) is a reliable tool derived from POSSUM to improve the prediction of mortality. In this paper, we utilized both models to determine the most suitable and feasible one that could be utilized in orthopedic surgery in China mainland. Methods: In this retrospective study, patients’ files were extracted randomly from the medical records department of the First Hospital Affiliated with Dalian Medical University for those underwent hip replacements between 1999 and 2006. The mortality and morbidity rates were predicted by P-POSSUM and POSSUM, respectively. A comparative analysis was performed between the observed and the predicted values as well as the Observed/Expected ratio (O:E). Results: A total of 206 patients were selected for this study after fulfilling the inclusion and exclusion criteria. The predicted mortality by P-POSSUM were not significantly different from the observed values (X2 = 2.10, P = 0.552). POSSUM appeared to be better with the observed morbidity (X2 = 2.766, P = 0.598), but had overestimated mortality. Conclusion: The POSSUM morbidity equation satisfactorily estimated the risk of postoperative complications, and the P-POSSUM mortality equation appeared to stratify the risk of death more accurate than the POSSUM.

Keywords

Hip Arthroplasty; Mortality; Morbidity; P-POSSUM; POSSUM

Conflicts of Interest

The authors declare no conflicts of interest.

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