Observational studyBMC anesthesiology2014
An evaluation of POSSUM and P-POSSUM scoring in predicting post-operative mortality in a level 1 critical care setting.
Observational study in BMC anesthesiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.
- Precision diagnosis: a view of the clinical decision support systems (CDSS) landscape through the lens of critical care.Journal of clinical monitoring and computing · 2017Pooled it
- Which Method Best Predicts Postoperative Complications: Deep Learning, Machine Learning, or Conventional Logistic Regression?Annals of gastroenterological surgery · 2026Review
- Head-to-Head Comparison: P-POSSUM and ACS-NSQIPCancers · 2024Article
- Prediction of mortality in secondary peritonitis: a prospective study comparing p-POSSUM, Mannheim Peritonitis Index, and Jabalpur Peritonitis Index.Perioperative medicine (London, England) · 2023Article
- Comparison between P-POSSUM and NELA risk score for patients undergoing emergency laparotomy in Egyptian patients.BMC surgery · 2023Article
- Risk Prediction Models for Peri-Operative Mortality in Patients Undergoing Major Vascular Surgery with Particular Focus on Ruptured Abdominal Aortic Aneurysms: A Scoping Review.Journal of clinical medicine · 2023Article
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- Article
- Morbimortality assessment in abdominal surgery: are we predicting or overreacting?BMC surgery · 2022Observational
- Consultant versus trainee led surgery and impact on outcome following an emergency colonic resection.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2021Article
- A Comparison of the P-POSSUM and NELA Risk Score for Patients Undergoing Emergency Laparotomy in Singapore.World journal of surgery · 2021Article
- Optimizing classical risk scores to predict complications in head and neck surgery: a new approach.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2021Article
- Trial of remote continuous versus intermittent NEWS monitoring after major surgery (TRaCINg): a feasibility randomised controlled trial.Pilot and feasibility studies · 2020Article
- The statistical importance of P-POSSUM scores for predicting mortality after emergency laparotomy in geriatric patients.BMC medical informatics and decision making · 2020Article
- Development of a preoperative risk score on admission in surgical intermediate care unit in gastrointestinal cancer surgery.Perioperative medicine (London, England) · 2020Article
- POSSUM and P-POSSUM Scoring in Hip Fracture Mortalities.Geriatric orthopaedic surgery & rehabilitation · 2020Article
- Prognostic Value of P-POSSUM and Osteopenia for Predicting Mortality After Emergency Laparotomy in Geriatric Patients.Bulletin of emergency and trauma · 2019Article
- Emergency surgery in older patients.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2019Article
- Frailty and emergency surgery in the elderly: protocol of a prospective, multicenter study in Italy for evaluating perioperative outcome (The FRAILESEL Study).Updates in surgery · 2018Observational
- Risk-adjusted treatment selection and outcome of patients with acute cholecystitis.Langenbeck's archives of surgery · 2017Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPOSSUM and P-POSSUM are used in the assessment of outcomes in surgical patients. Neither scoring systems' accuracy has been established where a level 1 critical care facility (level 1 care ward) is available for perioperative care. We compared POSSUM and P-POSSUM predicted with observed mortality on a level 1 care ward.
methodsA prospective, observational study was performed between May 2000 and June 2008. POSSUM and P-POSSUM scores were calculated for all postoperative patients who were admitted to the level 1 care ward. Data for post-operative mortality were obtained from hospital records for 2552 episodes of patient care. Observed vs expected mortality was compared using receiver operating characteristic (ROC) curves and the goodness of fit assessed using the Hosmer-Lemeshow equation.
resultsROC curves show good discriminative ability between survivors and non-survivors for POSSUM and P-POSSUM. Physiological score had far higher discrimination than operative score. Both models showed poor calibration and poor goodness of fit (Hosmer-Lemeshow). Observed to expected (O:E) mortality ratio for POSSUM and P-POSSUM indicated significantly fewer than expected deaths in all deciles of risk.
conclusionsOur data suggest a 30-60% reduction in O:E mortality. We suggest that the use of POSSUM models to predict mortality in patients admitted to level 1 care ward is inappropriate or that a recalibration of POSSUM is required to make it useful in a level 1 care ward setting.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.