POSSUM scoring system as an instrument of audit in lung resection surgery

Background. The physiological and operative severity score for the enumerat ion of mortality and morbidity (POSSUM) is a scoring system that was valida ted in general surgery with the aim of being used as an instrument to evalu ate surgical outcome. We applied POSSUM to a population of lung resection c andidates to assess its capability to predict postoperative complications. Methods. Two hundred fifty lung resection candidates were prospectively eva luated from 1993 through 1996. The POSSUM value was entered along with othe r variables (sex, smoking history, type of resection, pulmonary function te sts, arterial carbon dioxide, serum albumin level, total lymphocyte count, neoadjuvant chemotherapy and radiotherapy, and diabetes) in a multivariate analysis to identify independent predictors of postoperative morbidity. Results. Logistic regression analysis showed POSSUM was predictive of posto perative complications, showing no significant difference between predicted and observed morbidity (chi(2) test, p > 0.05). Conclusions. We think POSSUM can be appropriately used as a tool of surgica l audit in lung resection operations. (C) 1999 by The Society of Thoracic S urgeons.