Estimation of mortality and morbidity risk of radical cystectomy using POSSUM and the Portsmouth predictor equation

INTRODUCTION - The Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity (POSSUM) and the Portsmouth predictor equation (P-POSSUM) are simple scoring systems used to estimate the risk of complications and death postoperatively.

We investigated the use of these scores to predict the postoperative risk in patients undergoing radical cystectomy (RC).

MATERIALS AND METHODS - In this retrospective study, we enrolled 280 patients who underwent RC for invasive bladder cancer between January 2003 and December 2011. Morbidity and mortality were predicted using the POSSUM and P-POSSUM equations. We further assessed the ability of the POSSUM and P-POSSUM to predict the mortality and morbidity risk in RC patients with a Clavien-Dindo classification of surgical complications of grade II or higher.

RESULTS - The observed morbidity and mortality rates were 58. 9% (165 patients) and 1. 8% (5 patients), respectively. Predicted morbidity using POSSUM was 49. 2% (138 patients) compared to the 58. 9% (165 patients) observed (P

CONCLUSIONS - The results of this study supported the efficacy of POSSUM combined with P-POSSUM to predict morbidity and mortality in patients undergoing RC. Further prospective studies are needed to better determine the usefulness of POSSUM and P-POSSUM for a comparative audit in urological patients undergoing RC.

Central European journal of urology. 2015 Oct 15 [Epub]

Toshihiko Masago, Shuichi Morizane, Masashi Honda, Tadahiro Isoyama, Tsutomu Koumi, Kouji Ono, Hiroyuki Kadowaki, Takehiro Sejima, Atsushi Takenaka

Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan. , Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan. , Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan. , Division of Urology, Tottori Prefectural Central Hospital, Tottori, Japan. , Division of Urology, Japanese Red Cross Society Matsue Hospital, Matsue, Japan. , Division of Urology, Japanese Red Cross Society Tottori Hospital, Tottori, Japan. , Division of Urology, Saninrousai Hospital, Yonago, Japan. , Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan. , Division of Urology, Department of Surgery, Tottori University Faculty of Medicine, Yonago, Japan.

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