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POSSUM and P-POSSUM overpredict mortality for carotid endarterectomy

Renwick, P.M; Kuhan, G.; Abidia, A. F.; Wijesinghe, L. D.; Chetter, I. C.; Johnson, B. F.; Wilkinson, A .R.; Abidia, AF; Renwick, P. M.; Wilkinson, AR; McCollum, P. T.; Johnson, BF; Wijesinghe, LD; McCollum, PT


P.M Renwick

G. Kuhan

A. F. Abidia

L. D. Wijesinghe

B. F. Johnson

A .R. Wilkinson

AF Abidia

P. M. Renwick

AR Wilkinson

P. T. McCollum

BF Johnson

LD Wijesinghe

PT McCollum


Objectives: the aim was to test the predictive accuracy of POSSUM and P-POSSUM on patients undergoing CEA. Design: retrospective and prospective study. Materials: 499 CEAs performed by four vascular surgeons from a single unit from 1992-99. The median age was 68 (range 38-86) and 60% were men. Methods: physiological parameters, operative parameters and the 30-day mortality were collected. Predicted mortality for each patient was calculated using POSSUM and P-POSSUM equations. Patients were stratified into risk groups and observed and predicted deaths were compared. Accuracy of the prediction was assessed using chi-squared analysis. Results: the observed 30-day mortality was 1.8% (9/499). The predicted deaths using POSSUM and P-POSSUM analysis were 49 and 25 respectively compared to nine observed deaths. There was significant evidence of lack of fit of both models in predicting mortality (chi-squared analysis, p<0.05). Conclusions: POSSUM and P-POSSUM overpredict mortality and are unsuitable for comparative audit of CEA. Models developed specific for CEA might accurately predict mortality.


Kuhan, G., Abidia, A. F., Wijesinghe, L. D., Chetter, I. C., Johnson, B. F., Wilkinson, A. .., …McCollum, P. T. (2002). POSSUM and P-POSSUM overpredict mortality for carotid endarterectomy. European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 23(3), 209-211.

Journal Article Type Article
Acceptance Date Nov 9, 2001
Online Publication Date May 25, 2002
Publication Date Mar 31, 2002
Print ISSN 1078-5884
Electronic ISSN 1532-2165
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 23
Issue 3
Pages 209-211
Keywords Surgery; Cardiology and Cardiovascular Medicine
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