The Evaluation Of Improved POSSUM And P-POSSUM Scoring System In Predicting The Postoperative Mortality And Morbidity In Elder Patients Of Trochanteric Fractures Of The Femur Undergoing Internal Fixation

[Objective]To evaluate improved POSSUM and P-POSSUM scoring system in predicting the postoperative mortality and morbidity in the elder patients of trochanteric fractures of the femur undergoing internal fixation.[Methods]116 cases of elder patients of trochanteric fractures of 1^st hospital of Guangzhou TCM(from January 2007 to March 2009) were analyzed retrospectively.Analyze morbus internus before operation,the operation processes,the complication,and evaluate it using improved POSSUM and P-POSSUM scoring system.By using the appropriate regression equation,the predicted postoperative mortality and morbidity of complication were compared with the Dbserved results.Finally,the application of x² test whether there is a statistical difference.[Results]In this group,a total of 116 cases,40 cases of male,female 76 cases,the average age is 79.84±9.09 years old,the average physiology score 20.79±4.67,the average operative severity score 11.78±1.83.Evans typeâ… degrees 12 cases of type 1,accounting for 10.34%;2 degrees 60 cases, accounting for 51.72%;3 to 4 degrees 41 cases,accounting for 35.34%;â…¡type 3 cases,accounting for 2.59%.Combined preoperative diagnosis of internal diseases marked 73 cases(63.48%).The complications occurred in 35 cases, accounting for 30.17%.POSSUM scoring system in accordance with the forecast number of 48 cases of post-operative complications.According to x² test,there is no significant difference(x² test,P＞0.05).2 cases of death,accounting for 1.72%.Both of them are female patients,average age of 84.00±5.66 years old.By POSSUM mortality prediction equation to predict the death of 11 cases, the result is significantly higher than actual values,so there is a statistical difference(x²test,P＜0.05);by P-POSSUM mortality prediction equation to predict the death of 3cases,there is no significant statistical difference(x² test,P＞0.05).Conclusion?Improved POSSUM scoring msystera may be appropriately used to predict the morbidity of complication and P-POSSUM to mortality in patients of hip Fracture; Elder patients with trochanteric fractures of the femur and morbus internus could pass perioperatively time safely by preoperative therapy and post-op treatment.