POSSUM系统评估高龄人工股骨头置换手术并发症风险的临床应用

目的应用POSSUM评分系统评估高龄人工股骨头置换手术并发症发生概率，探讨POSSUM评估系统对人工股骨头置换手术风险评估的临床价值，指导临床治疗。方法回顾人工股骨头置换手术103例，用POSSUM对所有患者评分并评估手术并发症概率，绘制ROC曲线，评价POSSUM系统对手术并发症的评估能力。结果103例患者发生并发症19例，并发症组的术前生理学评分、手术严重度评分及预测并发症概率均高于元并发症组，差异有统计学意义（P〈0．05）。绘制ROC曲线下面积为0．805。结论患者术前生理学评分、手术严重度评分增高易发生手术并发症，POSSUM系统评估人工股骨头置换手术并发症风险的能力为中等，有实际临床应用价值。

The clinical application of POSSUM scoring system in evaluate complications of elderly patients after hip hemiarthroplasty

Objective To access complication probability of the elderly after hemiarthroplasty using POSSUM scoring system, and to research the clinical application of risk assessment. Methods 103 cases of the elderly after hemiarthroplasty were reviewed to evaluate the predictive power of POSSUM scoring system. We score them and predict their probability of surgical complications using POSSUM scoring system, and draw ROC curve. Results Actual complications in 19 cases. Preoperative physiology score, severity score and the predicted probability of complica- tions are higher than the group without complications. The difference was statistically significant （P〈0.05） and the area under ROC curve was 0. 805. Conclusions ity score of the elderly is prone to complications it has actual clinical value. The increase of preoperative physiological score and operative sever The diagnostic accuracy of POSSUM scoring system is medium and