POSSUM与P-POSSUM评分对髋部骨折患者术后并发症发生率及死亡率预测作用的回顾性分析  

A retrospective analysis of the predictive effects of POSSUM and P-POSSUM on postoperative complication and mortality rates in hip fracture patients

作　　者：刘海龙[1] 

机构地区：[1]铁岭市中心医院骨科,辽宁112000

出　　处：《中国骨与关节杂志》2017年第6期451-454,共4页Chinese Journal of Bone and Joint

摘　　要：目的探讨改良生理学和手术严重性评分系统(POSSUM与P-POSSUM)对髋部骨折术后并发症发生率、病死率的预测作用。方法选取2013年1月至2015年12月在本院骨科接受髋部骨折手术治疗的92例进行研究,采用POSSUM与P-POSSUM对患者手术后进行并发症发生率、病死率进行预测,并与实际并发症发生率、病死率进行比较。结果 92例术后并发症发生27例,其中5例并发2种并发症,死亡1例;手术并发症发生率为29.35%、病死率为1.09%;POSSUM评分系统预测92例髋部骨折手术后并发症为31例(33.70%)与实际发生并发症27例(29.35%)比较差异无统计学意义(P>0.05);POSSUM评分系统预测92例髋部骨折手术后死亡8例(8.70%)高于实际病死率1例(1.09%),差异有统计学意义(P<0.05);P-POSSUM评分系统预测92例髋部骨折手术后死亡3例(3.26%)与实际病死率1例(1.09%)比较差异无统计学意义(P>0.05)。结论 POSSUM评分系统预测髋部骨折手术后并发症具有较高的临床价值,P-POSSUM评分系统预测髋部骨折手术后患者病死率具有较高的临床价值。Objective To explore the predictive effects of the physiological and operative severity score for the enumeration of mortality and morbidity （ POSSUM ） and its Portsmouth modification （ P-POSSUM ） on the complication and mortality rates after hip fracture surgery. Methods The study was conducted in 92 patients with hip fractures treated in our hospital from January 2013 to December 2015. The POSSUM and P-POSSUM scoring systems were used to predict the postoperative complication and mortality rates, which were then compared with the actual complication and mortality rates. Results Postoperative complications occurred in 27 of 92 cases, among whom 5 cases had 2 kinds of complications and 1 case died. The rate of surgical complications was 29.35%, and the mortality rate was 1.09%. According to the POSSUM scoring system, 31 of 92 cases were predicted to have postoperative complications （ 33.70% ）, and the differences were not statistically significant when compared with 27 cases with actual complications （ 29.35% ） （ P 〉 0.05 ）. According to the POSSUM scoring system, the predicted mortality rate was 8.70% in 8 of 92 cases, which was higher than the actual mortality rate 1.09% in 1 case, and the differences were statistically significant （ P 〈 0.05 ）. According to the P-POSSUM scoring system, the predicted mortality rate was 3.26% in 3 of 92 cases, and the differences were not statistically significant when compared with the actual mortality rate 1.09% in 1 case （ P 〉 0.05 ）. Conclusions The POSSUM scoring system to predict postoperative complications in hip fracture patients has a high clinical value, and the P-POSSUM scoring system also has a high clinical value in predicting the mortality rate after hip fracture surgery.

关 键 词：髋部 髋骨折 手术后并发症 死亡率 POSSUM/P-POSSUM评分系统 

分 类 号：R687.3[医药卫生—骨科学]