Evaluation and validation of Physiological and Operative Severity Score for the enumeration of mortality and morbidity and Portsmouth-POSSUM scores in predicting morbidity and mortality in patients undergoing head and neck cancer surgeries

Nupur Karan; Suhail Siddiqui; Kailash S Sharma; Gouri H Pantvaidya; Jigeeshu V Divatia; Atul P Kulkarni

doi:10.1002/hed.26354

Evaluation and validation of Physiological and Operative Severity Score for the enumeration of mortality and morbidity and Portsmouth-POSSUM scores in predicting morbidity and mortality in patients undergoing head and neck cancer surgeries

Head Neck. 2020 Oct;42(10):2968-2974. doi: 10.1002/hed.26354. Epub 2020 Jul 27.

Authors

Nupur Karan¹, Suhail Siddiqui², Kailash S Sharma³, Gouri H Pantvaidya⁴, Jigeeshu V Divatia⁵, Atul P Kulkarni⁶

Affiliations

¹ Department of Neuroanaesthesia and Critical Care, NIMHANS, Bangalore, India.
² Department of Critical Care Medicine, King George's Medical University Faculty of Medical Sciences, Lucknow, Uttar Pradesh, India.
³ Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India.
⁴ Head & Neck Surgical Oncology, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India.
⁵ Department of Anaesthesia, Critical Care & Pain, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India.
⁶ Division of Critical Care Medicine, Department of Anaesthesia, Critical Care & Pain, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, India.

PMID: 32715529
DOI: 10.1002/hed.26354

Abstract

Background: Identification of risk factors for perioperative complications helps in the prognostication. We wanted to determine whether Physiological and Operative Severity Score for the enumeration of mortality and morbidity (POSSUM) and Portsmouth-POSSUM (P-POSSUM) can be used in patients undergoing head and neck oncosurgery.

Methods: We conducted a retrospective analysis of 1265 patients after they had major head and neck oncosurgeries. Demographic, surgical and outcome data was collected. We separately analyzed data for patients who had undergone cancer surgery for oral cavity, pharynx, and larynx. We calculated the POSSUM and P-POSSUM scores.

Results: POSSUM scoring system had moderate discrimination (AUC = 0.61) and good calibration (P = .36) for the entire study cohort and in the subgroup. Since there were no deaths in the entire cohort, we were not able to check predictive ability of the scores, for mortality.

Conclusions: We found that POSSUM had moderate discrimination and good calibration for morbidity prediction in head and neck cancer surgeries, as well as for the selected subgroup.

Keywords: P-POSSUM; POSSUM; head neck surgery; morbidity; oncosurgery; risk prediction models.

MeSH terms

Head and Neck Neoplasms* / surgery
Humans
Morbidity
Postoperative Complications / epidemiology
Retrospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index