An evaluation of the POSSUM surgical scoring system
An evaluation of the POSSUM surgical scoring system
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DOI：
10.1002/bjs.1800830628
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发表时间：
1996-06-01
影响因子：
9.6
通讯作者：
Prout, WG
中科院分区：
文献类型：
--
作者：
Whiteley, MS;Prytherch, DR;Prout, WG
POSSUM（发病率和死亡率计数的生理和手术严重程度评分）已被研究为一种可能的手术审核系统，为期 9 个月，使用一般手术工作量 28% 的样本，对死亡率或生存率作为终点进行分析。在此样本中，公布的死亡率 POSSUM 预测方程将死亡高估了两倍以上，大部分高估发生在风险最低的组（预测死亡率低 10%），其中死亡被高估了六倍。这是用于审计目的的最重要的组，因为它包含大多数手术患者并且由接受小手术的健康患者组成。已发布的死亡率预测方程返回的最低预测死亡率为 1.08%，明显远高于对于进行小手术的健康患者的预期，对一组 1485 例手术进行 Logistic 回归，以生成死亡率的局部预测方程。该过程给出了一个与观察到的死亡率非常吻合的预测方程，并给出了 0.20% 的最低预测死亡风险。之前发布的死亡率 POSSUM 预测方程在使用逻辑回归拟合优度标准检验进行测试时表现不佳，必须进行修改。
POSSUM (Physiological and Operative Severity Score for the enUmeration of Morbidity and mortality) has been studied as a possible surgical audit system for a 9-month interval using a sample of 28 per cent of the general surgical workload, Mortality or survival was analysed as an endpoint. Ira this sample the published POSSUM predictor equation for mortality overpredicted deaths by a factor of more than two, The bulk of the overpredict lon occurred in the group aii lowest risk (predicted mortality 10 per cent Oh less), in which death was overpredicted by a factor of six. This is the most important group for audit purposes since it contains the majority of surgical patients and is composed of fit patients undergoing minor surgery The published predictor equation for mortality returns a minimum predicted mortality of 1.08 per cent, clearly far higher than that expected Tor a fit patient having minor surgery, Logistic regression was done on a set of 1485 surgical episodes to generate a local predictor equation for mortality. This process gave a predictor equation that fitted well with the observed mortality rate and gave a minimum predicted risk of mortality of 0.20 per cent, The previously published POSSUM predictor equation for mortality performed badly when tested using a standard test of goodness of fit for logistic regression and must be modified.