The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .
POSSUM and Portsmouth POSSUM for predicting mortality. Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity.
BACKGROUND There is a need for an accurate measure of surgical outcomes so that hospitals and surgeons can be compared properly regardless of case mix . POSSUM ( Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity ) uses a physiological score and an operative severity score to calculate risks of mortality and morbidity . In a previous small study it was found that Portsmouth POSSUM ( P-POSSUM ; a modification of the POSSUM system ) provided a more accurate prediction of mortality . METHODS Some 10000 general surgical interventions ( excluding paediatric and day cases ) were studied prospect ively between August 1993 and November 1995 . The POSSUM mortality equation was applied to the full 10000 surgical episodes . The 10000 patients were arranged in chronological order and the first 2500 were used as a training set to produce the modified P-POSSUM predictor equation . This was then applied prospect ively to the remaining 7500 patients arranged chronologically in five groups of 1500 . RESULTS The original POSSUM logistic regression equation for mortality overpredicts the overall risk of death by more than twofold and the risk of death for patients at lowest risk ( 5 per cent or less ) by more than sevenfold . The P-POSSUM equation produced a very close fit with the observed in-hospital mortality . CONCLUSION P-POSSUM provides an accurate method for comparative surgical audit
The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .