Related Experiment Videos
Portsmouth POSSUM models for abdominal aortic aneurysm surgery
D R Prytherch1, G L Sutton, J R Boyle
1Queen Alexandra Hospital, Portsmouth, UK. Dave.Prytherch@amail01.swest.nhs.uk
The British Journal of Surgery
|July 10, 2001
Summary
Existing risk models like P-POSSUM do not accurately predict outcomes for ruptured abdominal aortic aneurysms (AAA). A new, specific risk model is needed for emergency AAA surgery to improve patient outcome predictions.
Area of Science:
- Vascular Surgery
- Surgical Outcomes
- Risk Modeling
Background:
- The Portsmouth Physiological and Operative Severity Score for enUmeration of Mortality and morbidity (P-POSSUM) is used for comparative surgical audits.
- P-POSSUM accurately models general and vascular surgery patients but may not suit ruptured abdominal aortic aneurysm (AAA) cases due to their unique nature.
Purpose of the Study:
- To evaluate the applicability of existing P-POSSUM equations for predicting outcomes in patients undergoing surgery for abdominal aortic aneurysms (AAA).
- To determine if a specific risk model is required for ruptured AAA patients.
Main Methods:
- Analysis of P-POSSUM data from 444 AAA admissions (213 emergency, 231 elective) between 1993 and 2000.
- Application of general surgery and vascular surgery P-POSSUM equations.
- Development and prospective testing of logistic regression models for emergency AAA repairs.
Main Results:
- Existing P-POSSUM equations accurately modeled elective AAA repairs but failed for emergency AAA repairs and combined data.
- Admission method was identified as a crucial factor not included in P-POSSUM.
- A new logistic regression model developed from emergency AAA data successfully predicted outcomes in a separate test set.
Conclusions:
- Ruptured abdominal aortic aneurysms (AAA) represent a distinct patient group requiring a specialized risk prediction model.
- Current general and vascular surgical risk models are inadequate for emergency AAA surgery.