Background: The prediction of surgical treatment results is commonly used in medicine. In vascular surgery p-POSSUM is proposed as good tool for estimating the risks and death after operation.
Aim: p-POSSUM efficacy assessment in the prediction of death, complication and cost of treatment in vascular surgery.
Material and methods: Patients (1242) were treated during a period of one year in the Vascular Surgery Department of Pomeranian Medical University in Szczecin. Surgical treatment was employed in 762 cases (61.35%) and pharmacological treatment in 126 cases (10.06%). Moreover, 354 patients underwent endovascular procedures (28.5%) including angioplasty and stenting. The analytical method used was a retrospective, not randomized analysis.
Results: We observed 14 (1.13%) deaths, and 108 (8.69%) cases presenting complications. The predicted rate of complication was 25.34 per cent while that of mortality was 2.47 per cent. In fact, both values turned out to be over-predictions in the whole group, with the estimated risk being more suitable for mortality, than for complication. Only in endovascular procedures the risk assessment based on P-POSSUM calculator was accurate. We also found a linear correlation between cost and the estimated death rate, as well as between cost and the estimated complication rate. Moreover, a 1 per cent increase in the P-POSSUM rate was reflected by a minimal cost increase which was not practically significant. Furthermore, a linear regression model can explain only 1 to 4% of cases (r2 = 0.01 to 0.044) leading one to draw the conclusion that while the P-POSSUM scale is suitable for assessing the death rate in vascular surgery, it is not appropriate for evaluating the cost of treatment in vascular surgery.

Polish Surgery 2010, 12, 59–66