Audit of morbidity and mortality following neck of femur fracture using the POSSUM scoring system.

Full Abstract

AIMS:
The aims of this study were to compare the morbidity and mortality data for patients undergoing surgical fixation of a fractured neck of femur (during a 6-month period) to the predicted morbidity and mortality rates obtained from the POSSUM (Physiological and Operative Severity Score for the enUmeration of Morbidity and Mortality) scoring system, adapted for orthopaedic patients. The predictive accuracy of the orthopaedic POSSUM system is evaluated for this population. The 1-year mortality for the males and females of the study group (mean ages) is compared to the 1-year mortality of male and female New Zealanders of the same age.

METHODS:
Physiological and operative data was collected from patient notes; patient morbidity and mortality were obtained at 30 days and at 1 year postoperatively. The data were analysed with the orthopaedic POSSUM scoring system.

RESULTS:
225 complete datasets were obtained. The mean age of the patients was 83 years; 75% were female. The observed 30-day morbidity and mortality rates were 58% and 12% respectively. The observed 1-year mortality was 38% for males (mean age 79 years) and 29% for females (mean age 84 years). New Zealand census data predicts 7% and 6.4% mortality respectively based on these mean ages.

CONCLUSIONS:
The POSSUM system allocates patients into groups of varying risk. The observed data shows higher numbers of complications, including death, in patients allocated into higher risk groups. The 1-year mortality is much higher than that predicted based on mean patient age from the New Zealand abridged life table.

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Author information

Author/s: Young, William (W); Seigne, Richard (R); Bright, Shona (S); Gardner, Marysha (M);

Affiliation: Department of Anaesthesia, Christchurch Hospital, Christchurch, New Zealand. wyoung(-atsign-)doctors.org.uk

Journal and publication information

Publication Type: Comparative Study; Journal Article

Journal: The New Zealand medical journal (N Z Med J), published in New Zealand. (Language: eng)

Reference: 2006-; vol 119 (issue 1234) : pp U1986

Dates: Created 2006/05/23; Completed 2006/06/13; Revised 2006/11/15;

PMID: 16718297, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: N Z Med J. 2006;119(1234):U1981. (PMID: 16718292)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Age Distribution
Aged
Aged, 80 and over
Female
Femoral Neck Fractures - classification; mortality; surgery
Humans
Male
Medical Audit
New Zealand - epidemiology

Outcome Assessment (Health Care)
Postoperative Complications - epidemiology
Predictive Value of Tests
Prospective Studies
ROC Curve
Risk Assessment - methods
Severity of Illness Index
Sex Distribution
Survival Analysis

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