<ArticleSet>
<Article>
<Journal>
<PublisherName>Trauma Research Center</PublisherName>
<JournalTitle>Bulletin of Emergency And Trauma</JournalTitle>
<Issn>2322-2522</Issn>
<Volume>7</Volume>
<Issue>3 JUL</Issue>
<PubDate>
<Year>2019</Year>
<Month>07</Month>
<Day>01</Day>
</PubDate>
</Journal>
<ArticleTitle>Prognostic Value of P-POSSUM and Osteopenia for Predicting Mortality After Emergency Laparotomy in Geriatric Patients</ArticleTitle>
<FirstPage>870</FirstPage>
<LastPage>870</LastPage>
<Language>EN</Language>
<AuthorList>
<Author>
<FirstName>Rebecka</FirstName>
<LastName>Ah</LastName>
<Affiliation>. shahin.mohseni@yahoo.com</Affiliation>
</Author>
<Author>
<FirstName>MB</FirstName>
<LastName>BChir</LastName>
</Author>
<Author>
<FirstName>Yang</FirstName>
<LastName>Cao</LastName>
</Author>
<Author>
<FirstName>Hakan</FirstName>
<LastName>Geijer</LastName>
</Author>
<Author>
<FirstName>Kardo</FirstName>
<LastName>Taha</LastName>
</Author>
<Author>
<FirstName>Sahar</FirstName>
<LastName>Pourhossein-Sarmeh</LastName>
</Author>
<Author>
<FirstName>Peep</FirstName>
<LastName>Talving</LastName>
</Author>
<Author>
<FirstName>Olle</FirstName>
<LastName>Ljungqvist</LastName>
</Author>
<Author>
<FirstName>Shahin</FirstName>
<LastName>Mohseni</LastName>
</Author>
</AuthorList>
<History>
<PubDate>
<Year>2019</Year>
<Month>02</Month>
<Day>04</Day>
</PubDate>
<PubDate>
<Year>2019</Year>
<Month>05</Month>
<Day>16</Day>
</PubDate>
<PubDate>
<Year>2019</Year>
<Month>05</Month>
<Day>13</Day>
</PubDate>
</History>
<Abstract>Objective: To evaluate the Portsmouth-Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (P-POSSUM) in comparison with other risk factors for mortality including osteopenia as an indicator for frailty in geriatric patients subjected to emergency laparotomy. Methods: All geriatric patients (≥65 years) undergoing emergency laparotomy at a single university hospital between 1/2015 and 12/2016 were included in this cohort study. Demographics and outcomes were retrospectively collected from medical records. Association between prognostic markers and 30-day mortality was assessed using Poisson and backward stepwise regression models. Prognostic value was assessed using receiver operating characteristic (ROC) curves.Results: 209 patients were included with a mean age of 76 ± 7.3 years. American Society of Anesthesiologists (ASA) classification, age, indication and type of surgery, hypotension, transfusion requirement and current malignancy proved to be statistically significant predictors of 30-day mortality. P-POSSUM mortality was statistically significant in the backward stepwise regression (incidence rate ratio=1.58, 95% CI: 1.16–2.15, p=0.004) while osteopenia was not. P-POSSUM had poor prognostic value for 30-day mortality with an area under the ROC curve (AUC) of 0.59. The prognostic value of P-POSSUM improved significantly when adjusting for patient covariates (AUC=0.83).Conclusion: P-POSSUM and osteopenia alone hardly predict 30-day mortality in geriatric patients following emergency laparotomy. P-POSSUM adjusted for other patient covariates improves the prediction.</Abstract>
<ObjectList>
<Object>
<Param>Emergency Surgery</Param>
</Object>
<Object>
<Param>Emergency Laparotomy</Param>
</Object>
<Object>
<Param>Geriatric</Param>
</Object>
<Object>
<Param>Mortality</Param>
</Object>
</ObjectList>
</Article>
</ArticleSet>