Application Value Of POSSUM And P-POSSUM Scoring Model In Predicting Valve Replacement

Objective To explore the application value of POSSUM and Portsmouth Modified POSSUM scoring model in predicting traditional median open thoracic valve replacement.Methods A total of 182 patients undergoing valve replacement were scored by POSSUM to predict the complication and mortality of the patients,and compared with the actual values.At the same time,some factors that may affect the prognosis of the patients were studied.From the ratio of the actual value to the predicted value and the receiver operating characteristic curve,find the critical value,use Logistic regression analysis to predict the stability of the model,and explore the relevant factors that affect the treatment result.Results Of the 182 cases,84 had a good prognosis group,98 had complications,and 16 died;the difference in the physiological score,surgical score,and predictive value of thecomplication-free group was not statistically significant(P> 0.05).Compared with the survival group,the score and prediction value were higher,and the difference was statistically significant(P <0.05).Factors that may affect the prognosis are smoking,preoperative complications with underlying disease,preoperative EF levels,aortic clamping time,and number of valve replacements.POSSUM predicts 41.41 cases of complications and 82 actual cases;122.5 cases of death and 16 actual cases,the difference is statistically significant;Portsmouth Modified POSSUM predicts 18.38 deaths and 16 actual cases,the difference is not statistically significant(?2 =0.30,P>0.05).The ROC curve of the predicted mortality model was stable.The AUC was 0.770,the critical value of the predicted death value was 0.126,the sensitivity was 0.629,and the specificity was 0.228.Logistic regression proves that the model has good stability,and the factors affecting the patient’s outcome are age,respiration,blood sodium,type of surgery and whether it is malignant.Conclusion The POSSUM scoring model is not suitable for predicting the complication rate and mortality of traditional median open thoracic valve replacement,and the Portsmouth Modified POSSUM scoring model has a high clinical value in predicting the mortality of traditional median open thoracic valve replacement.