The Evaluation Of Improved POSSUM And P-POSSUM Scoring System Inpredicting The Postoperative Mortality And Morbidity In Elder Patients Of Low Energy Intertrochanteric Fractures Of The Femur Undergoing Internal Fixation

[Objective]To evaluate improved POSSUM and P-POSSUM scoring system in predicting the postoperative mortality and morbidity in the elder patients of low energy intertrochanteric fractures and be closed reduction and Gamma nail internal fixation undergoing internal fixation.[Methods]112cases of elder patients of low energy intertrochanteric fractures and be closed reduction and Gamma nail internal fixation of department of orthopaedic, the first Affiliated hospital of Kunming Medical University(from January2011and February2013) were analyzed retrospectively. Analyze preoperative diagnosis of internal diseases, the operation processes, the complication, and evaluate it using improved POSSUM and P-POSSUM scoring system. By using the appropriate regression equation, the predicted postoperative mortality and morbidity of complication were compared with the observed results. Finally, the application of x2test whether there is a statistical difference. [Results]In this group, a total of112cases,41cases of male,71cases of female, the average age is78.46±8.12years old, the average operative score12.32±1.24. Evans type Ⅰ degrees10cases of type1,accounting for3.57%;2degrees60cases, accounting for53.57%;3to4degrees38cases, accounting for33.92%; Ⅱ type4cases, accounting for3.57%. Combined preoperative diagnosis of internal diseases marked69cases, accounting for60.61%. The complications occurred in32cases, accounting for28.57%. POSSUM scoring system in accordance with the forecast number of36cases of post-operative complications, but the actual complications occurred in32cases. According to χ2test, there is no significant difference (χ2test, P>0.05).1cases of death(elderly male patients and94years old), accounting for0.89%. By POSSUM mortality prediction equation to predict the death of9cases, the result is significantly higher than actual values, so there is a statistical difference (χ2test, P<0.05); by P-POSSUM mortality prediction equation to predict the death of2cases, there is no significant statistical difference(χ2test, P>0.05).[Conclusion]Improved POSSUM scoring system may be appropriately used to predict the morbidity of complication and P-POSSUM to mortality in the elder patients of low energy intertrochanteric fractures and be closed reduction and Gamma nail internal fixation; Elder patients with intertrochanteric fractures and preoperative diagnosis of internal diseases could pass perioperatively time safely by preoperative therapy and tolerance internal fixation of fracture.