Significance of the POSSUM scoring system in predicting morbidity and mortality in elderly patients after pancreatoduodenectomy

摘要

Background/Aims: To explore the significance of POSSUM scoring system (Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity) in predicting morbidity and mortality in elderly Chinese patients undergoing pancreatoduodenectomy (PD). Methodology: Between January 2001 and January 2011, 396 patients underwent PD in our hospital; POSSUM and P-POSSUM score were retrospectively calculated for each patient and correlated with observed morbidity and mortality, respectively. Results: The mortality and morbidity rates were 4.11% and 42.8%, respectively. The POSSUM showed "good fit" in morbidity prediction (p=0.103), it also showed "good fit" in mortality prediction but only in elderly patients (p=0.078). While in young patients, POSSUM showed "poor fit" in both morbidity (p=0.002) and mortality (p=0.012) prediction. Conclusions: The POSSUM showed significance in predicting morbidity and mortality in elderly Chinese patients, and is helpful in guiding surgical management decisions. A modified equation for POSSUM scoring system based on large-scale clinical PD data should be developed to achieve a better fit in low-risk patients