P-POSSUM和POSSUM评分系统预测老年髋关节置换死亡率和并发症发生率的对比研究

目的应用生理学和手术严重度评分系统（p-POSSUM及POSSUM）对老年髋关节置换术死亡率和并发症率进行回顾性评估，探讨其对老年髋关节置换手术风险评估的价值。方法将141例髋关节置换手术病例，应用p-POSSUM和POSSUM预测手术死亡率和并发症率。比较P—POSSUM和POSSUM对两组病例的预测价值。结果根据POSSUM系统预测，48例发生并发症，而实际发生并发症43例，预测值与实际值无显著差异；预测11例死亡，实际死亡3例，预测值明显高于实际值。根据P—POSSUM系统预测的死亡率（预测死亡4例，实际死亡3例），预测值与实际值无显著性差异。60岁以上组POSSUM预测并发症率、P—POSSUM预测死亡率与实际情况相符；60岁以下组POSSUM预测并发症率、P—POSSUM预测死亡率均高于实际情况。结论POSSUM对髋关节置换手术并发症率有较好的预测能力，而过高估汁手术死亡率；P—POSSUM能准确地预测手术死亡率，其预测能力优于POSSUM；P-POSSUM和POSSUM尤其适用于60岁以上的老年髋关节置换患者。

The contrast study of P-POSSUM and POSSUM scoring system in predicting the mortality and morbidity in the aged patients underwent total hip arthroplasty

Objective To evaluate the value of P-POSSUM and POSSUM in predicting mortality and morbidity in the patients underwent total hip arthroplasty(THA).Methods 141 patients underwent THA were studied retrospectively using P-POSSUM and POSSUM scoring system to predict their mortality and morbidity.Subgroup analysis consisted of group A and B(over and under 60 years old) was performed to investigate the predictive capability of two scoring systems.Results There was no statistically difference between the patients with complications predicted by POSSUM and the observed(48 and 43,P>0.05).The observed deaths number agreed well with the predicted calculated by P-POSSUM(3 and 4) without significant difference(P>0.05).The prediction of POSSUM to morbidity and mortality in group A accorded with practical situation(P>0.05),but that in group B was higher than the observed.Conclusions POSSUM could have better predictive ability of morbidity,but overestimate mortality;P-POSSUM could accurately predict mortality than POSSUM,especially,two methods could be fitted for the patients aged over 60 years old.