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Preoperative risk evaluation of postoperative morbidity in IBD patients—impact of the POSSUM score

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Abstract

Background

The aim of this study was to assess the morbidity and mortality of patients undergoing surgery for infIammatory bowel disease (IBD) with special focus of the predictive value of the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) scoring system for preoperative risk adjustment of postoperative morbidity.

Methods

The operative notes and hospital files of 191 patients with IBD were analyzed. The POSSUM scoring system was used to predict morbidity rates after surgery. The physiological sub-score of the POSSUM score was analyzed with regard to its ability to predict postoperative complications.

Results

The overall complication rate was 27.7%, and the mortality was 0.5%. The morbidity rate predicted by POSSUM was 28.4% and the mortality rate 7.2%. The mean POSSUM-phys sub-score in patients without the major complications (anastomotic lekages, peritonitis, bleeding) was significant lower compared to patients with at least one of these complications (14.7 vs. 18.6; p < 0.001). Regarding the major complications separately, there were significant differences in the POSSUM-phys scores in patients developing a sepsis (14.1 vs. 23.4; p < 0.001) and/or a peritonitis (14.8 vs. 19.2; p = 0.05), whereas patients developing an anastomotic leakage/suture dehiscence or a postoperative bleeding did not differ significantly.

Conclusion

POSSUM was an accurate predictor of morbidity in IBD patients and overpredicted mortality. The POSSUM-phys score is a promising instrument for identifying patients at increased risk of developing major postoperative complications after surgery for IBD.

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Acknowledgment

We thank Ulrike Schulz for the excellent assistance in statistical calculations. Some of the data are part of the doctoral thesis of A.S.

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Correspondence to Jan-Hendrik Egberts.

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Egberts, JH., Stroeh, A., Alkatout, I. et al. Preoperative risk evaluation of postoperative morbidity in IBD patients—impact of the POSSUM score. Int J Colorectal Dis 26, 783–792 (2011). https://doi.org/10.1007/s00384-011-1179-7

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