open access

Vol 12, No 2 (2010)
Published online: 2011-02-04
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Efficacy of P-POSSUM calculator in prediction of early results and cost of treatment in vascular surgery

Arkadiusz Kazimierczak, Marcin Śledź, Piotr Gutowski, Renata Guzicka-Kazimierczak, Miłosław Cnotliwy, Samir Zeair, Rabih Samad
Chirurgia Polska 2010;12(2):59-66.

open access

Vol 12, No 2 (2010)
Published online: 2011-02-04

Abstract


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

Abstract


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

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Keywords

P-POSSUM; vascular surgery; costs evaluation

About this article
Title

Efficacy of P-POSSUM calculator in prediction of early results and cost of treatment in vascular surgery

Journal

Chirurgia Polska (Polish Surgery)

Issue

Vol 12, No 2 (2010)

Pages

59-66

Published online

2011-02-04

Bibliographic record

Chirurgia Polska 2010;12(2):59-66.

Keywords

P-POSSUM
vascular surgery
costs evaluation

Authors

Arkadiusz Kazimierczak
Marcin Śledź
Piotr Gutowski
Renata Guzicka-Kazimierczak
Miłosław Cnotliwy
Samir Zeair
Rabih Samad

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