Related Experiment Video
Updated: May 10, 2026
An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
Published on: January 27, 2010
Can POSSUM accurately predict post-operative complications risk in patients with abdominal Crohn's disease?
Giampaolo Ugolini1, Isacco Montroni, Giancarlo Rosati
1Department of Medical and Surgical Sciences, University of Bologna, Policlinico S.Orsola-Malpighi, Bologna, Italy.
Insights
The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) accurately predicts surgical complications in Crohn's disease (CD) patients. POSSUM scores also correlate with the Harvey-Bradshaw Index (HBI) and length of hospital stay.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Clinical Epidemiology
Background:
- Crohn's disease (CD) often affects young patients requiring surgery, frequently when severely ill.
- The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) is a tool for predicting 30-day surgical complications.
- Evaluating POSSUM's efficacy in CD patients undergoing surgery was the primary study aim.
Purpose of the Study:
- To assess the accuracy of POSSUM in predicting post-operative complications and mortality in patients with abdominal Crohn's disease.
- To explore the correlation between POSSUM, Harvey-Bradshaw Index (HBI), length of stay (LOS), and anastomotic leak in this patient cohort.
Main Methods:
- Prospective enrollment of 123 patients with abdominal CD undergoing elective or emergency surgery (2006-2011).
- Comparison of POSSUM-predicted morbidity/mortality with observed outcomes (O/E ratio).
- Logistic and linear regression analyses to evaluate POSSUM and HBI as predictors and their correlation with LOS and anastomotic leak.
Main Results:
- Portsmouth-POSSUM predicted 1.22% mortality (0% observed) and 22.04% morbidity (21.95% observed).
- POSSUM and HBI were significant univariate predictors of post-operative complications (OR 1.17 and 1.25, respectively).
- Significant correlations were found between POSSUM, HBI, and LOS.
Conclusions:
- POSSUM demonstrates precision in forecasting post-operative complications for patients with abdominal Crohn's disease.
- POSSUM scores show a significant correlation with the Harvey-Bradshaw Index in this population.
Background:
Although the majority of patients with Crohn's disease (CD) are young, they are often seriously ill when surgery is required. The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) is a risk prediction scoring system estimating 30-day complications. The primary endpoint was to evaluate POSSUM efficacy in this subgroup. The secondary endpoint was to determine any potential correlation between POSSUM, Harvey-Bradshaw Index (HBI), length of stay (LOS) and anastomotic leak.
Methods:
All patients affected by abdominal CD who underwent elective and emergency surgery from 2006 to 2011 were prospectively enrolled in the study. POSSUM expected morbidity and mortality were compared to the observed outcomes (O/E ratio). Logistic regression analysis was performed to evaluate POSSUM and HBI adequacy. Correlation between POSSUM, HBI, LOS and anastomotic leak was investigated with linear regression analysis.
Results:
One hundred twenty-three patients underwent abdominal surgery. The overall 30-day mortality rate estimated by the Portsmouth-POSSUM was 1.22% (95% confidence interval (CI) 0.4-3.6) while no deaths were observed (O/E = 0). The prediction regarding the post-operative complication rate was 22.04% (95% CI 11.1-51.2) and the observed overall morbidity rate was 21.95% (O/E = 0.99). The mean HBI score was 6.85 while LOS was 9.4 days. POSSUM and HBI were found to be significant predictors of post-operative complications at the univariate logistic regression analysis (OR 1.17 95% CI 1.06-1.30 and OR 1.25 95% CI 1.04-1.49, respectively). Linear regression analysis showed a significant correlation between POSSUM, HBI and LOS.
Conclusion:
POSSUM is precise in predicting post-operative complications in patients with abdominal CD. POSSUM correlates with HBI.
Related Concept Videos
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD: