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Ann Thorac Surg 1999;67:329-331
© 1999 The Society of Thoracic Surgeons

Original Articles

POSSUM scoring system as an instrument of audit in lung resection surgery

Alessandro Brunelli, MDa, Aroldo Fianchini, MDa, Rosaria Gesuita, MSb, Flavia Carle, PhDb,c

a Department of Thoracic Surgery, University of Ancona, Ancona, Italy
b Department of Epidemiology, Biostatistics and Medical Information Technology, University of Ancona, Ancona, Italy
c Department of Biomedical Sciences, University of Ancona, and Fon dazione Anziano Operato "Biancalana-Mastera," Ancona, Italy

Accepted for publication June 28, 1998.

Address reprint requests to Dr Brunelli, Via S. Margherita 23, 60129 Ancona, Italy

Background. The physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) is a scoring system that was validated in general surgery with the aim of being used as an instrument to evaluate surgical outcome. We applied POSSUM to a population of lung resection candidates to assess its capability to predict postoperative complications.

Methods. Two hundred fifty lung resection candidates were prospectively evaluated from 1993 through 1996. The POSSUM value was entered along with other variables (sex, smoking history, type of resection, pulmonary function tests, arterial carbon dioxide, serum albumin level, total lymphocyte count, neoadjuvant chemotherapy and radiotherapy, and diabetes) in a multivariate analysis to identify independent predictors of postoperative morbidity.

Results. Logistic regression analysis showed POSSUM was predictive of postoperative complications, showing no significant difference between predicted and observed morbidity ({chi}2 test, p > 0.05).

Conclusions. We think POSSUM can be appropriately used as a tool of surgical audit in lung resection operations.




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