摘要目的 应用骨科生理学和手术严重度评分(orthopedic version physiological and operatire severity score for the enumeration of mortality and morbidity,O-POSSUM)系统、朴茨茅斯(Portsmouth)-POSSUM(P-POSSUM)系统对骨科老年患者术后并发症率和病死率进行回顾性研究,探讨其对骨科老年患者手术风险评估的价值. 方法 收集2008年1月-2011年12月骨科老年住院患者839例,应用O-POSSUM、P-POSSUM系统预测术后病死率和并发症率,比较预测值与观察值差异. 结果 O-POSSUM系统预测230例并发症,而观察并发症182例,预测值与观察值差异无统计学意义(x2 =2.718,P ＞0.05);预测死亡46例,观察死亡3例,预测值高于观察值(x2=38.870,P＜0.01).P-POSSUM系统预测死亡16例,观察死亡3例,预测值高于观察值(x2=8.997,P＜0.01). 结论 O-POSSUM系统对骨科老年患者术后并发症率有较好的预测能力.而O-POSSUM系统、P-POSSUM系统均过高估计了病死率,运用时应谨慎.

abstractsObjective To retrospectively review the mortality and morbidity after orthopedic surgery for aged patients with reference to orthopedic version physiological and operative severity score for the enumeration of mortality and morbidity (O-POSSUM) and Portsmouth POSSUM (P-POSSUM) and validate the score' s accuracy in operative risk prediction.Methods O-POSSUM and P-POSSUM for mortality and morbidity were applied to 839 aged patients who had undergone orthopedic surgery between January 2008 and December 2011.Observed mortality and morbidity were compared with the expected values.Results O-POSSUM predicted 230 morbidities,but the observed value was 182 (x2 =2.718,P ＞ 0.05).O-POSSUM predicted 46 deaths,higher than the observed 3 deaths (x2 =38.870,P＜0.01).P-POSSUM predicted 16 deaths,higher than the observed 3 deaths (x2 =8.997,P ＜ 0.01).Conclusions O-POSSUM accurately predicts postoperative morbidity in aged orthopedic patients.However,O-POSSUM and P-POSSUM overpredicts the mortality and should be used with caution.