同济大学学报（医学版）2017，Vol.38Issue(1)：99-103,5.DOI:10.16118/j.1008-0392.2017.01.021
POSSUM系统预测高龄患者术后并发症的临床适用范围
Clinical application of POSSUM in predicting postoperative complications in elderly patients
摘要
Abstract
Objective To evaluate the clinical application of POSSUM in elderly patients undergoing orthopedic hip replacement surgery,non-orthopedic surgery or surgery of different category.Methods The predicted value of postoperative complication rate according to POSSUM system was scored and calculated.Differences between the predicted value and the actual value in 100 patients aged ≥70 years undergoing orthopedic hip replacement surgery and 200 patients ≥ 70 years undergoing nonorthopedic surgery or surgery of different category were analyzed.Results There was a significant difference in postoperative complication rate between the predicted value and the actual value (42.04％ vs 22％,x2 =9.191,P =0.002) in patients undergoing orthopedic hip replacement surgery.There were no significant differences in mean physiological index score [(25.05 ± 5.05) vs (24.49 ±5.40),Z=-0.80,P =0.936],mean operative severity score [(10.14 ±0.83) vs (9.96 ±0.86).Z=-1.086,P=0.278],and prediction values (44.22 ± 18.48)％ vs (41.56 ± 18.47)％,Z =-0.325,P =0.746] between patients with and without postoperative complications.There was no significant difference in postoperative complication rate between prediction value and actual value (47.33 ％ vs 19％,Z =-1.826,P =0.086) in patients undergoing non-orthopedic surgery or surgery of different category.There was no statistical difference in mean operative severity score [(10.42 ±1.57) vs (10.47 ± 2.16),Z =-0.477,P =0.633],but there were significant differences in physiological index mean score [(26.53 ± 5.97)vs (23.18 ± 4.55),Z =-3.122,P =0.002] and prediction values [(55.96 ± 20.17) ％ vs (45.32 ± 18.61) ％,Z =-2.853,P =0.004] between patients with and without postoperative complications.Conclusion The predictive value of POSSUM for postoperative complications in elderly patients is higher than the actual value.POSSUM can be used as a preoperative risk assessment tool for patients undergoing non-orthopedic or surgery of different category,while its application in patients undergoing orthopedic hip replacement surgery need to be further explored.关键词
预测/手术/并发症/高龄Key words
prediction/operation/complication/advanced age分类
医药卫生引用本文复制引用
李萍,杨雪,钱巧慧..POSSUM系统预测高龄患者术后并发症的临床适用范围[J].同济大学学报（医学版）,2017,38(1):99-103,5.基金项目
上海市卫生和计划委员会课题(20134130) （20134130）
