Details

Autor(en) / Beteiligte

• Madrazo, Zoilo
• Osorio, Javier
• Videla, Sebastián
• Sainz, Beatriz
• Rodríguez-González, Araceli
• Campos, Andrea
• Santamaría, Maite
• Pelegrina, Amalia
• González-Serrano, Carmen
• Aldeano, Aurora
• Sarriugarte, Aingeru
• Gómez-Díaz, Carlos Javier
• Ruiz-Luna, David
• García-Ruiz-de-Gordejuela, Amador
• Gómez-Gavara, Concepción
• Gil-Barrionuevo, Marta
• Vila, Marina
• Clavell, Arantxa
• Campillo, Beatriz
• Millán, Laura
• Olona, Carles
• Sánchez-Cordero, Sergi
• Medrano, Rodrigo
• López-Arévalo, Camilo Andrés
• Pérez-Romero, Noelia
• Artigau, Eva
• Calle, Miguel
• Echenagusia, Víctor
• Otero, Aurema
• Tebé, Cristian
• Pallarès, Natàlia
• Biondo, Sebastiano

Titel

P-POSSUM as mortality predictor in COVID-19-infected patients submitted to emergency digestive surgery. A retrospective cohort study

Ist Teil von

• International journal of surgery (London, England), 2021-12, Vol.96, p.106171-106171, Article 106171

Ort / Verlag

England: Elsevier Ltd

Erscheinungsjahr

2021

Quelle

MEDLINE

Beschreibungen/Notizen

• COVID-19 infection is associated with a higher mortality rate in surgical patients, but surgical risk scores have not been validated in the emergency setting. We aimed to study the capacity for postoperative mortality prediction of the P-POSSUM score in COVID-19-positive patients submitted to emergency general and digestive surgery. Consecutive patients undergoing emergency general and digestive surgery from March to June 2020, and from March to June 2019 in 25 Spanish hospitals were included in a retrospective cohort study. Main outcome: 30-day mortality. P-POSSUM discrimination was quantified by the area under the curve (AUC) of ROC curves; calibration was assessed by linear regression slope (β estimator); and sensitivity and specificity were expressed as percentage and 95% confidence interval (CI). 4988 patients were included: 177 COVID-19-positive; 2011 intra-pandemic COVID-19-negative; and 2800 pre-pandemic. COVID-19-positive patients were older, with higher surgical risk, more advanced pathologies, and higher P-POSSUM values (1.79% vs. 1.09%, p < 0.001, in both the COVID-19-negative and control cohort). 30-day mortality in the COVID-19-positive, intra-pandemic COVID-19-negative and pre-pandemic cohorts were: 12.9%, 4.6%, and 3.2%. The P-POSSUM predictive values in the three cohorts were, respectively: AUC 0.88 (95% CI 0.81–0.95), 0.89 (95% CI 0.87–0.92), and 0.91 (95% CI 0.88–0.93); β value 0.97 (95% CI 0.74–1.2), 0.99 (95% CI 0.82–1.16), and 0.78 (95% CI 0.74–0.82); sensitivity 83% (95% CI 61–95), 91% (95% CI 84–96), and 89% (95% CI 80–94); and specificity 81% (95% CI 74–87), 76% (95% CI 74–78), and 80% (95% CI 79–82). The P-POSSUM score showed a good predictive capacity for postoperative mortality in COVID-19-positive patients submitted to emergency general and digestive surgery. •P-POSSUM score has a good predictive capacity in COVID-19-infected patients.•Postoperative mortality after emergency gastrointestinal surgery can be effectively estimated.•The P-POSSUM score allows the identification of “high risk” patients during the pandemic.•The predictive capacity of this known surgical score exceeds other scores used during the pandemic.