The Clinic Significance Of Modified Possum In Predicting The Postoperative Morbidity In Urologic Patients

ObjectiveTo evaluate the applicability of using the modified physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) to forecast a cohort of urologic postoperative patients'prognostic and to supply the theory for using the POSSUM system in urology.MethodsPOSSUM factors from 696 consecutive patients undergoing urologic operations for various diseases in our department over a half year from July 2006 to December 2006 were randomized collected. In the modified POSSUM , ECG were evaluated more detailed ;BUN and abdominal cavity soiling were replaced by Cr and surgical field soiling respectively; the operative severity score of endourology were debased one grade compared to the open surgery; While other operative severity scores were classified 4 grades. The observed morbidity was compared with that prospected by the POSSUM scoring system.Results 1. The patients were divided into two groups which have complications or no complications. There were 126 patients with complications which including 110 male and 16 female and 570 patients without complications including 439 male and 131 female. The median value of the age,days in hospital,score of physiology and score of operative severity in the group with complications were 67,24,18 and 8, which in the group without complications were 54,13,13 and 7.The Mean Rank of the age,days in hospital,score of physiology and score of operative severity in the group without complications was lower than the group with complications(p<0.05).2.The morbidity was correlative with the patient's disease,the kind of surgery and the basal disease(p<0.05).3. There were 126 patients with complications while 111 patients were predicted by the POSSUM scoring system .Thus, the observed morbidity was not significantly different from predicted rate (p=0.318).Conclusion1. The modified POSSUM may be appropriately predicted the occurrence of postoperative patients'morbidity in the urologic department.2. The physiological score can be gained before the operation, according to which we could choose the best treatment for our patients.