POSSUM Predicts Hospital Mortality and Long-Term Survival in Patients With Hip Fractures
| Autor: | Afina S. Glas, Alexander Engel, Igande P. Oñorbe Genovesi, Paul R. Strating, Jan-Willem R. Mulder, Michiel L. P. van Zeeland |
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| Přispěvatelé: | Surgery, Urology, Other Research |
| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Critical Care and Intensive Care Medicine Risk Factors Fracture fixation Medicine Humans Hospital Mortality Survival analysis Netherlands Retrospective Studies Aged 80 and over Hip fracture business.industry Hip Fractures Incidence (epidemiology) Retrospective cohort study medicine.disease Prognosis Comorbidity Confidence interval Surgery Fracture Fixation Intramedullary Survival Rate Orthopedic surgery Female business Follow-Up Studies |
| Zdroj: | van Zeeland, M L P, Genovesi, I P O, Mulder, J W R, Strating, P R, Glas, A S & Engel, AF 2011, ' POSSUM Predicts Hospital Mortality and Long-Term Survival in Patients With Hip Fractures ', Journal of Trauma, vol. 70, no. 4, pp. E67-E72 . https://doi.org/10.1097/TA.0b013e3181edbf7a Journal of Trauma, 70(4), E67-E72. Lippincott Williams and Wilkins |
| ISSN: | 0022-5282 |
| Popis: | Background Each year, some 18,000 Dutch residents, most of them elderly, suffer a hip fracture. These patients constitute a major, and increasing, healthcare problem with high mortality. In an ageing population, not only the incidence of hip fractures will increase but also comorbidity. Comorbidity is a major cause of high mortality. The physiologic and operative severity score for the enumeration of mortality and morbidity (POSSUM) system predicts mortality and morbidity in surgical patients using physiologic and operative factors. Methods For 272 consecutive patients who were treated in our hospital for hip fractures, all complications were registered, and orthopedic POSSUM was performed. Total survival was registered with a mean follow-up of 58 months. Discriminating performance of POSSUM was estimated using receiver-operating curves. After validation, patients were divided into three equal large groups, termed low-risk group, intermediate-risk group, and high-risk group. Kaplan-Meier survival curves were made of each group. Results Orthopedic POSSUM performed well in predicting mortality with an area under the curve of 0.83 (95% confidence interval 0.76-0.89) and morbidity with an area under the curve of 0.83 (95% confidence interval 0.76-0.90). Three groups that composed of 92 (low risk), 93 (intermediate risk), and 87 (high risk) patients differed significantly in inhospital mortality, all complications, severe complications, and total survival. Conclusion This study has shown that the orthopedic POSSUM is an excellent predictor of inhospital mortality and long-term survival in patients suffering from hip fractures. It is a reasonable predictor of severe postoperative complications. The orthopedic POSSUM is a useful risk stratification and audit tool. |
| Databáze: | OpenAIRE |
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