Valoración de la calidad asistencial quirúrgica mediante el sistema POSSUM

Introduction. The use of the scoring system known as POSSUM (Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity) is increasingly widespread in the operating room. It aids in the assessment of the rates of morbidity and mortality fit to the risk of an individual patient regardless of his physiological condition at the time of surgery and the risk associated with the difficulty of the procedure. The objective of the present study is to validate the predictive forms of the POSSUM system in a second-level surgical department in Spain.
Patients and method. A series of 677 patients were studied prospectively in terms of 12 physiological factors prior to surgery and six surgical factors assessed postoperatively. The morbidity and mortality of the series was recorded and the predictable morbidity and mortality rates were calculated using the POSSUM system.
Results. Of the 677 patients studied, 184 (27.2%) underwent emergency surgery and 493 (72.8%) had elective surgery. The mean physiological score was 15.27 points (range: 12 to 40 points), while the mean surgical score was 8.94 points (range: 6 to 33 points). Postoperative morbidity was detected in 126 patients (18.6%) and 17 patients (2.5%) died during the postoperative period. According to the predictive formulas of the POSSUM system, 112 patients (16.55%) should present postoperative morbidity and 18 (2.61%) should die. There were no statistically significant differences. There was only one case of overprediction.