COVID-19 infection possesses a higher mortality rate in surgical patients, but surgical risk scores need validation in the emergency setting. A recent study investigated the capacity for postoperative mortality prediction of the P-POSSUM score in COVID-19-positive patients submitted to emergency general and digestive surgery.

Consecutive patients undergoing emergency general and digestive surgery were included in a retrospective cohort study and 30-day mortality was examined. 

Overall, 4988 patients were enrolled in the study, including 177 COVID-19-positive; 2011 intra-pandemic COVID-19-negative; and 2800 pre-pandemic. 

The results described that the COVID-19-positive patients were older, having higher surgical risk, more progressive pathologies, and more elevated P-POSSUM values (1.79% vs. 1.09%, in both the COVID-19-negative and control cohort). 30-day mortality in the COVID-19-positive was 12.9%, intra-pandemic COVID-19-negative was 4.6% and pre-pandemic cohorts was 3.2%. The P-POSSUM predictive values in the three cohorts were, respectively: AUC 0.88, 0.89 and 0.91; β value 0.97, 0.99 and 0.78; sensitivity 83%, 91% and 89%; and specificity 81%, 76% and 80%.

Thus, the P-POSSUM score demonstrated a good predictive capacity for postoperative mortality in COVID-19-positive patients presented to emergency general and digestive surgery.

Source: Madrazo Z, Osorio J, Videla S, et al. P-POSSUM as mortality predictor in COVID-19-infected patients submitted to emergency digestive surgery. A retrospective cohort study. Int J Surg. 2021;96:106171. doi:10.1016/j.ijsu.2021.106171