Abstract
Purpose
The ageing of the population in developed countries has led to an increased number of patients with hip fractures all over the world. POSSUM and P-POSSUM scores predict morbidity and mortality of patients who will be undergoing a surgical treatment. The aim of this study was to evaluate accuracy of these two scores in hip-fractured patients.
Materials and methods
Between January and December 2012, in our department 144 patients were hospitalised for femoral neck fractures according to the grade III or IV of Garden’s classification treated with total hip arthroplasty or endoprosthesis. POSSUM scores and P-POSSUM scores were calculated for each patient with complete clinical data. We then calculated the observed and the expected ratio.
Results
134 patients were eligible: 110 females and 24 males. The mean age for women was 79 years, and the mean age for men was 84 years. We observed 13 deaths and 66 complications. The POSSUM scores predicted 16 deaths and 60 complications, while P-POSSUM scores predicted 6 deaths. The O/E ratio for POSSUM mortality was 0.81 and for P-POSSUM was 2.17, while POSSUM morbidity was 1.1.
Conclusion
In our study, we have shown that on the one hand, the POSSUM score predicted accurately both the mortality and morbidity in patients undergoing surgery for the femoral neck fracture, while on the other hand, the P-POSSUM score underestimated them. For this reason, we believe that the POSSUM is indeed a good audit tool, which can accurately predict both mortality and morbidity in a cohort of patients.
Similar content being viewed by others
References
Johnell O, Kanis J (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int 17:1726–1733
Dettoni F, Peveraro A, Dettoni A, Rossi R, Castoldi F, Zareh A, Amberti F, Giai Via A, Bonasia D (2012) Epidemiology of hip fractures in northwestern Italy: a multicentric regional study on incidence of hip fractures and their outcome at 3-year follow-up. Musculoskelet Surg 96(1):41–46
Copeland GP, Jones D, Walters M (1991) POSSUM: scoring system for surgical audit. Br J Surg 78:355–360
Mohamed K, Copeland GP, Boot DA (2002) An assessment of the possum system in orthopaedic surgery. J Bone Jt Surg (Br) 84B:35–39
Hirose J, Ide J, Irie H (2009) New equations for predicting postoperative risk in patients with hip fracture. Clin Orthop Relat Res 467:3327–3333
Wright DM, Blanckley S, Stewart GJ, Copeland GP (2008) The use of orthopaedic POSSUM as an audit tool for fractured neck of femur. Inj Int J Care Inj 39:430–435
Whiteley MS, Prytherch DR, Weaver PC, Prout WG (1996) An evaluation of the POSSUM surgical scoring system. Br J Surg 83:812–815
Gholve PA, Kosygan KP, Sturdee SW, Faraj AA (2005) Multidisciplinary integrated care pathway for fractured neck of femur. A prospective trial with improved outcome. Inj Int J Care Inj 36:93–98
Lawrence TM, White CT, Wenn R, Moran CG (2005) The current hospital costs of treating hip fracture. Inj Int J Care Inj 36:88–91
Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359(9319):1761–1767
Ions GK, Stevens J (1987) Prediction of survival in patients with femoral neck fractures. J Bone Jt Surg (Br) 69(3):384–387
Wallace RGH, Lowry JH, McLeod NW et al (1986) A simple grading system to guide the prognosis after hip fractures in the elderly. BMJ 293(6548):665
Lewis JR, Hassan SKZ, Wenn RT, Moran CG (2006) Mortality and serum urea electrolytes on admission for hip fracture patients. Inj Int J Care Inj 37:698–704
Ramanathan TS, Moppett IK, Wenn R, Moran CG (2005) POSSUM scoring system for patients with fractured neck of femur. Br J Anaesth 94(4):430–433
Conflict of interest
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bonicoli, E., Parchi, P., Piolanti, N. et al. Comparison of the POSSUM score and P-POSSUM score in patients with femoral neck fracture. Musculoskelet Surg 98, 201–204 (2014). https://doi.org/10.1007/s12306-013-0294-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12306-013-0294-8