Use of the Portsmouth Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity ('P-POSSUM') to predict morbidity in patients undergoing surgery with reconstruction for temporal bone malignancy

J Laryngol Otol. 2022 Dec;136(12):1271-1274. doi: 10.1017/S0022215122000767. Epub 2022 May 26.

Abstract

Objective: The Portsmouth Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity ('P-POSSUM') is a two-part scoring system that includes a physiological assessment and a measure of operative severity. This study sought to determine whether risk estimates for this scoring system could be used in major head and neck reconstructive surgery.

Method: A retrospective review was performed of patients undergoing resection for a temporal bone malignancy in a single head and neck centre in Dublin, Ireland, from 2002 to 2021.

Results: The mean ± standard deviation morbidity estimate calculated using the scoring system was 47.6 per cent ± 19.5 per cent. The actual rate of complications was 47 per cent. The optimal cut-off for the scoring system was calculated using the Youden index from the receiver operating characteristic curve, which was 40.5 per cent in this case.

Conclusion: The study indicates that the Portsmouth Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity is a useful tool for predicting morbidity risk in patients undergoing head and neck resection with reconstruction for temporal bone malignancies.

Keywords: Morbidity; Postoperative Complications; Risk Factors; Temporal Bone.

MeSH terms

  • Bone Neoplasms*
  • Humans
  • Morbidity
  • Osteosarcoma*
  • Postoperative Complications / epidemiology
  • ROC Curve
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index