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Estimation of mortality and morbidity risk of radical cystectomy using POSSUM and the Portsmouth predictor equation.

Masago T, Morizane S, Honda M, Isoyama T, Koumi T, Ono K, Kadowaki H, Sejima T, Takenaka A - Cent European J Urol (2015)

Bottom Line: Predicted morbidity using POSSUM was 49.2% (138 patients) compared to the 58.9% (165 patients) observed (P <0.0001).The mortality risk estimated by P-POSSUM was not significantly different from the observed mortality rate.The results of this study supported the efficacy of POSSUM combined with P-POSSUM to predict morbidity and mortality in patients undergoing RC.

View Article: PubMed Central - PubMed

Affiliation: Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan.

ABSTRACT

Introduction: The Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity (POSSUM) and the Portsmouth predictor equation (P-POSSUM) are simple scoring systems used to estimate the risk of complications and death postoperatively. We investigated the use of these scores to predict the postoperative risk in patients undergoing radical cystectomy (RC).

Material and methods: In this retrospective study, we enrolled 280 patients who underwent RC for invasive bladder cancer between January 2003 and December 2011. Morbidity and mortality were predicted using the POSSUM and P-POSSUM equations. We further assessed the ability of the POSSUM and P-POSSUM to predict the mortality and morbidity risk in RC patients with a Clavien-Dindo classification of surgical complications of grade II or higher.

Results: The observed morbidity and mortality rates were 58.9% (165 patients) and 1.8% (5 patients), respectively. Predicted morbidity using POSSUM was 49.2% (138 patients) compared to the 58.9% (165 patients) observed (P <0.0001). Compared to the observed death rate of 1.8% (5 patients), predicted mortality using POSSUM and P-POSSUM was 12.1% (34 patients) and 3.9% (11 patients), respectively (P <0.0001 and P = 0.205). The mortality risk estimated by P-POSSUM was not significantly different from the observed mortality rate.

Conclusions: The results of this study supported the efficacy of POSSUM combined with P-POSSUM to predict morbidity and mortality in patients undergoing RC. Further prospective studies are needed to better determine the usefulness of POSSUM and P-POSSUM for a comparative audit in urological patients undergoing RC.

No MeSH data available.


Related in: MedlinePlus

Empirical receiver operating curves (ROCs) to assess the prediction of morbidity and mortality by the POSSUM, and the prediction of mortality by the P-POSSUM. The area under the curve (AUC) is used as a measure of overall diagnostic accuracy. A. The POSSUM morbidity does not accurately predict the observed morbidity. B. The POSSUM mortality does not accurately predict the observed mortality. C. The P-POSSUM mortality accurately predicts observed mortality.
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Figure 0001: Empirical receiver operating curves (ROCs) to assess the prediction of morbidity and mortality by the POSSUM, and the prediction of mortality by the P-POSSUM. The area under the curve (AUC) is used as a measure of overall diagnostic accuracy. A. The POSSUM morbidity does not accurately predict the observed morbidity. B. The POSSUM mortality does not accurately predict the observed mortality. C. The P-POSSUM mortality accurately predicts observed mortality.

Mentions: Empirical ROCs to assess the prediction of morbidity and mortality by the POSSUM and mortality by the P-POSSUM are shown in Figure 1. The AUC was 0.514 (CI, 0.446–0.583), 0.514 (0.446–0.583), and 0.518 (0.451–0.586), respectively.


Estimation of mortality and morbidity risk of radical cystectomy using POSSUM and the Portsmouth predictor equation.

Masago T, Morizane S, Honda M, Isoyama T, Koumi T, Ono K, Kadowaki H, Sejima T, Takenaka A - Cent European J Urol (2015)

Empirical receiver operating curves (ROCs) to assess the prediction of morbidity and mortality by the POSSUM, and the prediction of mortality by the P-POSSUM. The area under the curve (AUC) is used as a measure of overall diagnostic accuracy. A. The POSSUM morbidity does not accurately predict the observed morbidity. B. The POSSUM mortality does not accurately predict the observed mortality. C. The P-POSSUM mortality accurately predicts observed mortality.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4643712&req=5

Figure 0001: Empirical receiver operating curves (ROCs) to assess the prediction of morbidity and mortality by the POSSUM, and the prediction of mortality by the P-POSSUM. The area under the curve (AUC) is used as a measure of overall diagnostic accuracy. A. The POSSUM morbidity does not accurately predict the observed morbidity. B. The POSSUM mortality does not accurately predict the observed mortality. C. The P-POSSUM mortality accurately predicts observed mortality.
Mentions: Empirical ROCs to assess the prediction of morbidity and mortality by the POSSUM and mortality by the P-POSSUM are shown in Figure 1. The AUC was 0.514 (CI, 0.446–0.583), 0.514 (0.446–0.583), and 0.518 (0.451–0.586), respectively.

Bottom Line: Predicted morbidity using POSSUM was 49.2% (138 patients) compared to the 58.9% (165 patients) observed (P <0.0001).The mortality risk estimated by P-POSSUM was not significantly different from the observed mortality rate.The results of this study supported the efficacy of POSSUM combined with P-POSSUM to predict morbidity and mortality in patients undergoing RC.

View Article: PubMed Central - PubMed

Affiliation: Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan.

ABSTRACT

Introduction: The Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity (POSSUM) and the Portsmouth predictor equation (P-POSSUM) are simple scoring systems used to estimate the risk of complications and death postoperatively. We investigated the use of these scores to predict the postoperative risk in patients undergoing radical cystectomy (RC).

Material and methods: In this retrospective study, we enrolled 280 patients who underwent RC for invasive bladder cancer between January 2003 and December 2011. Morbidity and mortality were predicted using the POSSUM and P-POSSUM equations. We further assessed the ability of the POSSUM and P-POSSUM to predict the mortality and morbidity risk in RC patients with a Clavien-Dindo classification of surgical complications of grade II or higher.

Results: The observed morbidity and mortality rates were 58.9% (165 patients) and 1.8% (5 patients), respectively. Predicted morbidity using POSSUM was 49.2% (138 patients) compared to the 58.9% (165 patients) observed (P <0.0001). Compared to the observed death rate of 1.8% (5 patients), predicted mortality using POSSUM and P-POSSUM was 12.1% (34 patients) and 3.9% (11 patients), respectively (P <0.0001 and P = 0.205). The mortality risk estimated by P-POSSUM was not significantly different from the observed mortality rate.

Conclusions: The results of this study supported the efficacy of POSSUM combined with P-POSSUM to predict morbidity and mortality in patients undergoing RC. Further prospective studies are needed to better determine the usefulness of POSSUM and P-POSSUM for a comparative audit in urological patients undergoing RC.

No MeSH data available.


Related in: MedlinePlus