POSSUM评分系统及其改良方法预测人工关节置换的风险

背景：POSSUM及P-POSSUM评分已被证明是普通外科最为可靠并得到广泛应用的评分系统，但其在骨科领域、特别是人工关节置换方面的应用报道较少。 目的：探讨POSSUM评分系统在预测人工关节置换后风险的价值。 方法：选择2008-01/2010-10解放军第二炮兵总医院骨科收治的接受人工全髋关节置换、双极股骨头关节置换及全膝关节置换的患者186例，均为单侧关节置换。分别应用POSSUM及P-POSSUM评分系统预测置换并发症率和病死率。 结果与结论：按照POSSUM评分预测，186例患者置换后30 d内应有32例(17%)发生并发症，实际发生28例(15%)，按照P-POSSUM评分预测，本组置换后30 d内应有5例死亡(3%)，实际发生2例(1%)，两组相比，差异无显著性意义(P > 0.05)。提示应用POSSUM及P-POSSUM评分系统预测置换并发症率和病死率与真实结果具有较强的一致性。

Effects of POSSUM Score System and its modification in evaluating post-operative risk for arthroplasties

BACKGROUND:It is important to predict the risks of arthroplasties before operation. Among the systems of prediction of morbidity and mortality, POSSUM and P-POSSUM scores have been proved to be the most reliable scoring systems. However, its application in arthroplasties is rarely reported. OBJECTIVE:To evaluate the value of POSSUM and P-POSSUM scores in predicting morbidity and mortality in patients undergoing arthroplasties． METHODS:From 2008-01 to 2010-10, 186 patients underwent arthroplasties were studied retrospectively using POSSUM and P-POSSUM scoring systems to predict the morbidity and mortality. RESULTS AND CONCLUSION:There was no statistically difference between the patients with complications predicted by POSSUM (32 cases, 17%) and the observed (28 cases, 15%) within 30 days after implantation (P > 0.05). The observed deaths number (5 cases, 3%) also had no significant difference from the predicted value by P-POSSUM (2 cases, 1%). POSSUM and P-POSSUM scoring systems showed satisfied predictive ability of morbidity and mortality.