Prognostic Value of P-POSSUM and Osteopenia for Predicting Mortality After Emergency Laparotomy in Geriatric Patients

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Ah Rebecka; BChir M.B.; Cao Yang; Geijer Hakan; Taha Kardo; Pourhossein Sarmeh Sahar; Talving Peep; Ljungqvist Olle; Mohseni Shahin

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Journal: Bulletin of Emergency And Trauma Year:2019 | Volume:7 | Issue:3 Page(s): 223-231

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Title

Prognostic Value of P-POSSUM and Osteopenia for Predicting Mortality After Emergency Laparotomy in Geriatric Patients

Author(s)

Keywords

Emergency surgery

Emergency Laparotomy

Geriatric

Mortality

Abstract

Objective: To evaluate the Portsmouth-Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (P-POSSUM) in comparison with other risk factors for Mortality including osteopenia as an indicator for frailty in Geriatric patients subjected to Emergency Laparotomy. Methods: All Geriatric patients (≥ 65 years) undergoing Emergency Laparotomy at a single university hospital between 1/2015 and 12/2016 were included in this cohort study. Demographics and outcomes were retrospectively collected from medical records. Association between prognostic markers and 30-day Mortality was assessed using Poisson and backward stepwise regression models. Prognostic value was assessed using receiver operating characteristic (ROC) curves. Results: 209 patients were included with a mean age of 76 ± 7. 3 years. American Society of Anesthesiologists (ASA) classification, age, indication and type of surgery, hypotension, transfusion requirement and current malignancy proved to be statistically significant predictors of 30-day Mortality. P-POSSUM Mortality was statistically significant in the backward stepwise regression (incidence rate ratio=1. 58, 95% CI: 1. 16– 2. 15, p=0. 004) while osteopenia was not. P-POSSUM had poor prognostic value for 30-day Mortality with an area under the ROC curve (AUC) of 0. 59. The prognostic value of P-POSSUM improved significantly when adjusting for patient covariates (AUC=0. 83). Conclusion: P-POSSUM and osteopenia alone hardly predict 30-day Mortality in Geriatric patients following Emergency Laparotomy. P-POSSUM adjusted for other patient covariates improves the prediction.

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Erratum: Correction of Mortality Outcome Parameter

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APA: Copy

Ah, Rebecka, BChir, M.B., Cao, Yang, Geijer, Hakan, Taha, Kardo, Pourhossein Sarmeh, Sahar, Talving, Peep, Ljungqvist, Olle, & Mohseni, Shahin. (2019). Prognostic Value of P-POSSUM and Osteopenia for Predicting Mortality After Emergency Laparotomy in Geriatric Patients. BULLETIN OF EMERGENCY AND TRAUMA BEAT, 7(3), 223-231. SID. https://sid.ir/paper/335174/en

Vancouver: Copy

Ah Rebecka, BChir M.B., Cao Yang, Geijer Hakan, Taha Kardo, Pourhossein Sarmeh Sahar, Talving Peep, Ljungqvist Olle, Mohseni Shahin. Prognostic Value of P-POSSUM and Osteopenia for Predicting Mortality After Emergency Laparotomy in Geriatric Patients. BULLETIN OF EMERGENCY AND TRAUMA BEAT[Internet]. 2019;7(3):223-231. Available from: https://sid.ir/paper/335174/en

IEEE: Copy

Rebecka Ah, M.B. BChir, Yang Cao, Hakan Geijer, Kardo Taha, Sahar Pourhossein Sarmeh, Peep Talving, Olle Ljungqvist, and Shahin Mohseni, “Prognostic Value of P-POSSUM and Osteopenia for Predicting Mortality After Emergency Laparotomy in Geriatric Patients,” BULLETIN OF EMERGENCY AND TRAUMA BEAT, vol. 7, no. 3, pp. 223–231, 2019, [Online]. Available: https://sid.ir/paper/335174/en

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