Validation of the P-POSSUM score in predicting outcomes in emergency craniotomy: A prospective observational study
Background: The Portsmouth physiological and operative severity score for the enumeration of mortality and morbidity (P-POSSUM) is an established tool for predicting surgical outcomes. However, its applicability and accuracy in predicting post-operative mortality in patients undergoing emergency cra...
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Manipal College of Medical Sciences, Pokhara
2024-12-01
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| Series: | Asian Journal of Medical Sciences |
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| Online Access: | https://www.nepjol.info/index.php/AJMS/article/view/69514 |
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| author | Hari Prakash Rai Shivam Sharma |
| author_facet | Hari Prakash Rai Shivam Sharma |
| author_sort | Hari Prakash Rai |
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| description | Background: The Portsmouth physiological and operative severity score for the enumeration of mortality and morbidity (P-POSSUM) is an established tool for predicting surgical outcomes. However, its applicability and accuracy in predicting post-operative mortality in patients undergoing emergency craniotomy require further validation.
Aims and Objectives: This study aims to validate the accuracy of the P-POSSUM score in predicting post-operative mortality in patients undergoing emergency craniotomy.
Materials and Methods: A prospective observational study was conducted over 2 years (June 2022–May 2024) at Maharani Laxmi Bai Medical College, Jhansi. Patients undergoing emergency craniotomy were included in the study. Data were collected on pre-operative physiological parameters and intraoperative variables to calculate the P-POSSUM score. The primary outcome was post-operative mortality within 30 days. Statistical analysis involved receiver operating characteristic curve analysis and the Hosmer-Lemeshow test to assess the predictive accuracy and calibration of the P-POSSUM score.
Results: A total of 200 patients were included in the study. The mean age was 53±17 years; 113 were male and 87 were female. The P-POSSUM score demonstrated good predictive accuracy for post-operative mortality with an area under the ROC curve of 0.85 (95% CI: 0.79–0.91). Calibration analysis using the Hosmer–Lemeshow test showed good calibration (P=0.23). Observed mortality was 56 (28%) compared to an expected 61, resulting in an observed-to-expected mortality ratio of 0.92.
Conclusion: The P-POSSUM score is a reliable and accurate tool for predicting post-operative mortality in patients undergoing emergency craniotomy. Its integration into clinical practice can enhance risk stratification and inform clinical decision-making. Further studies with larger cohorts and diverse populations are warranted to generalize these findings. |
| format | Article |
| id | doaj-art-cf77a01d80de4f8587026aed91623c17 |
| institution | Kabale University |
| issn | 2467-9100 2091-0576 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Manipal College of Medical Sciences, Pokhara |
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| series | Asian Journal of Medical Sciences |
| spelling | doaj-art-cf77a01d80de4f8587026aed91623c172024-12-05T05:17:27ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762024-12-011512130135https://doi.org/10.3126/ajms.v15i12.69514Validation of the P-POSSUM score in predicting outcomes in emergency craniotomy: A prospective observational studyHari Prakash Rai 0https://orcid.org/0009-0009-0388-8432Shivam Sharma 1https://orcid.org/0009-0003-8013-7866Assistant Professor, Department of Neurosurgery, M.L.B. Medical College, Jhansi - 284 128, Uttar Pradesh, India Junior Resident, Department of Surgery, M.L.B. Medical College, Jhansi - 284 128, Uttar Pradesh, India Background: The Portsmouth physiological and operative severity score for the enumeration of mortality and morbidity (P-POSSUM) is an established tool for predicting surgical outcomes. However, its applicability and accuracy in predicting post-operative mortality in patients undergoing emergency craniotomy require further validation. Aims and Objectives: This study aims to validate the accuracy of the P-POSSUM score in predicting post-operative mortality in patients undergoing emergency craniotomy. Materials and Methods: A prospective observational study was conducted over 2 years (June 2022–May 2024) at Maharani Laxmi Bai Medical College, Jhansi. Patients undergoing emergency craniotomy were included in the study. Data were collected on pre-operative physiological parameters and intraoperative variables to calculate the P-POSSUM score. The primary outcome was post-operative mortality within 30 days. Statistical analysis involved receiver operating characteristic curve analysis and the Hosmer-Lemeshow test to assess the predictive accuracy and calibration of the P-POSSUM score. Results: A total of 200 patients were included in the study. The mean age was 53±17 years; 113 were male and 87 were female. The P-POSSUM score demonstrated good predictive accuracy for post-operative mortality with an area under the ROC curve of 0.85 (95% CI: 0.79–0.91). Calibration analysis using the Hosmer–Lemeshow test showed good calibration (P=0.23). Observed mortality was 56 (28%) compared to an expected 61, resulting in an observed-to-expected mortality ratio of 0.92. Conclusion: The P-POSSUM score is a reliable and accurate tool for predicting post-operative mortality in patients undergoing emergency craniotomy. Its integration into clinical practice can enhance risk stratification and inform clinical decision-making. Further studies with larger cohorts and diverse populations are warranted to generalize these findings.https://www.nepjol.info/index.php/AJMS/article/view/69514p-possum score; emergency craniotomy; postoperative mortality; predictive accuracy; neurosurgical risk assessment |
| spellingShingle | Hari Prakash Rai Shivam Sharma Validation of the P-POSSUM score in predicting outcomes in emergency craniotomy: A prospective observational study Asian Journal of Medical Sciences p-possum score; emergency craniotomy; postoperative mortality; predictive accuracy; neurosurgical risk assessment |
| title | Validation of the P-POSSUM score in predicting outcomes in emergency craniotomy: A prospective observational study |
| title_full | Validation of the P-POSSUM score in predicting outcomes in emergency craniotomy: A prospective observational study |
| title_fullStr | Validation of the P-POSSUM score in predicting outcomes in emergency craniotomy: A prospective observational study |
| title_full_unstemmed | Validation of the P-POSSUM score in predicting outcomes in emergency craniotomy: A prospective observational study |
| title_short | Validation of the P-POSSUM score in predicting outcomes in emergency craniotomy: A prospective observational study |
| title_sort | validation of the p possum score in predicting outcomes in emergency craniotomy a prospective observational study |
| topic | p-possum score; emergency craniotomy; postoperative mortality; predictive accuracy; neurosurgical risk assessment |
| url | https://www.nepjol.info/index.php/AJMS/article/view/69514 |
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