[Comparison of surgical outcomes in two populations with risk adjustment using the POSSUM system]

Abstract

Objective: To validate the application of the Physiological and Operative Severity Score for the enumeration of Mortality and morbidity (POSSUM) system in Uruguay in order to validate its broader utility not only for predicting surgical results but also for comparing surgical outcomes in two different healthcare institutions in Montevideo.

Patients and method: A total of 815 patients in 2 institutions (one public and the other private) were prospectively studied. A POSSUM score was assigned, expected morbidity and mortality according to POSSUM [(and its variant, Portsmouth PSSUM (p-POSSUM)] were calculated, and postoperative complications and deaths were registered.

Results: Observed morbidity and mortality were within the range predicted by POSSUM (and p-POSSUM) application. The use of these scores showed no significant differences in surgical outcomes between the two institutions, considering the different mix of patients and interventions.

Conclusion: The authors conclude that the POSSUM scoring system can be used in different surgical settings. In the future, this system will be highly useful to compare different surgical outcomes among institutions, regions and countries all over the world.