Physiological and operative severity score for the enumeration of mortality and morbidity frailty, and perioperative quality of life in the elderly

• Type: Article in International Scientific Journal
• Date: 2019

Authors

Lima, MJM (Author) Other; Cristelo, DFM (Author) Other; J Mourão (Author) FMUP

Journal

Title: Saudi Journal of Anaesthesia

Vol. 13

Pages: 3-8

ISSN: 1658-354X

Publisher: Wolters Kluwer Health

Indexing

ISI Web of Knowledge - 1 Citation

Scopus - 1 Citation

Other information

Authenticus ID: P-00Q-30Y

DOI: 10.4103/sja.sja_275_18

Abstract (EN): Background: Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) is a validated instrument used to predict morbidity. The aim of our study was to evaluate the performance of the POSSUM score system on predicting perioperative frailty and quality of life (QOL) in elderly surgical patients. Patients and Methods: An observational prospective study was conducted during 3 months. POSSUM was used to determine operative morbidity risk. Patients with a POSSUM score >= 26 were considered as having a high POSSUM (PHP). WHODAS 2.0, EuroQOL-5 dimensions (EQ-5D), Charlson score, and the Clinical Frailty Scale were used to assess the QOL and frailty. Chi-square, Fisher's exact, or Mann-Whitney tests were used for comparisons. Results: Two hundred and thirty-five patients were included. Median age was 69 years; 58% were ASA I/II and 42% ASA III/IV. Frailty was present in 53 patients (23%). Median POSSUM score was 26. Patients PHP were older (median age 71 vs. 68, P= 0.008), more frequently ASA III/IV (P= 0.001), had higher median Charlson scores (7 vs. 5, P= 0.006) and were more frail (49% vs. 26%, P < 0.001). PHP presented more problems in EQ-5D dimensions preoperatively (mobility: 59% vs 41%, P = 0.008; care: 41% vs. 25%, P = 0.013; activity: 52% vs. 32%, P = 0.002; pain: 59% vs. 45%, P = 0.041) but not anxiety (P= 0.137). Three months after surgery, PHP patients presented more problems in mobility: 63% vs. 38%, P < 0.001; care: 48% vs. 31%, P = 0.009; activity: 58% vs. 44%, P = 0.036; pain 59% vs. 37%, P = 0.001 and anxiety: 54% vs. 50%, P = 0.025. Conclusions: Patients PHP were trailer and had worse perioperative QOL.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 6