A prospective evaluation of preoperative risk evaluation system for geriatric orthopedic patients

安 帅(An Shuai，Dept Orthop，Xuanwu Hosp，Cap Med Univ，Beijing 100053)… ∥ Chin J Orthop Trauma.－2011，13(2).－140～143

A prospective evaluation of preoperative risk evaluation system for geriatric orthopedic patients

安 帅(An Shuai，Dept Orthop，Xuanwu Hosp，Cap Med Univ，Beijing 100053)… ∥ Chin J Orthop Trauma.－2011，13(2).－140～143

ObjectiveTo evaluate the correlation and efficacy of Preoperative Risk Evaluation System for Geriatric Orthopedic Patients(PRESGOP)，Acute Physiology and Chronic Health Evaluation(APACHE)and Physiological and Operative Score for the Enumeration of Mortality and Morbidity(POSSUM)in predicting the postoperative complications and mortality in old orthopedic patients.MethodsFrom January，2009 to February，2010，404 geriatric orthopedic patients who underwent surgery in our department were enrolled in the present prospective trial.All cases were divided into 4 groups according to presence or absence of complication and death respectively.The 4 groups were evaluated by PRESGOP，APACHE and POSSUM scoring systmes and then compared using T test.The 3 kinds of scores were also compared for their correlations and Receiver Operating Characteristic(ROC)curves.ResultsComparisons of the complication and complication-free groups，only in PRESGOP death and death-free groups have significant differences(P＜0.05).The Pearson correlative coefficient of PRESGOP and APACHE was 0.300，while that of PRESGOP and POSSUM was 0.538.The correlative coefficient of APACHE and POSSUM was 0.490.The areas under ROC curve associated with 3 total scores accumulated and complications were 0.771(PRESGOP)，0.634(APACHE)，and 0.751(POSSUM).And the areas under ROC curve depicted by 3 predictive mortalities were 0.920(PRESGOP)，0.877(APACHE)，and 0.836(POSSUM).ConclusionThe 3 evaluation systmes are correlative and valid in predicting postoperative complications and mortality in old orthopedic patients.The PRESGOP systme may be more exact in predictive efficacy for Chinese old orthopaedic patients.6 refs，2 figs，4 tabs.

(Authors)