David Prytherch

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BACKGROUND There is a need for an accurate measure of surgical outcomes so that hospitals and surgeons can be compared properly regardless of case mix. POSSUM (Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity) uses a physiological score and an operative severity score to calculate risks of mortality and morbidity. In(More)
BACKGROUND The aim of the study was to develop a dedicated colorectal Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (CR-POSSUM) equation for predicting operative mortality, and to compare its performance with the Portsmouth (P)-POSSUM model. METHODS Data were collected prospectively from 6883 patients undergoing(More)
POSSUM (Physiological and Operative Severity Score for the enUmeration of Morbidity and mortality) has been studied as a possible surgical audit system for a 9-month interval using a sample of 28 per cent of the general surgical workload. Mortality or survival was analysed as an endpoint. In this sample the published POSSUM predictor equation for mortality(More)
AIM OF STUDY To develop a validated, paper-based, aggregate weighted track and trigger system (AWTTS) that could serve as a template for a national early warning score (EWS) for the detection of patient deterioration. MATERIALS AND METHODS Using existing knowledge of the relationship between physiological data and adverse clinical outcomes, a thorough(More)
Hospitalised patients, who suffer cardiac arrest and require unanticipated intensive care unit (ICU) admission or die, often exhibit premonitory abnormalities in vital signs. Sometimes, the deterioration is well documented, though there is little discernable evidence of intervention. In other cases, monitoring and recording of vital signs is infrequent or(More)
INTRODUCTION The present study was designed to develop a dedicated oesophagogastric model for the prediction of risk-adjusted postoperative mortality in upper gastrointestinal surgery (O-POSSUM). METHODS Using 1042 patients undergoing oesophageal (n = 538) or gastric (n = 504) surgery between 1994 and 2000 the Portsmouth predictor equation for mortality(More)
INTRODUCTION Early warning scores (EWS) are recommended as part of the early recognition and response to patient deterioration. The Royal College of Physicians recommends the use of a National Early Warning Score (NEWS) for the routine clinical assessment of all adult patients. METHODS We tested the ability of NEWS to discriminate patients at risk of(More)
BACKGROUND The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) criteria have been used to assess surgical risk in patients in the UK. The aim was to determine how applicable these criteria are to patients undergoing surgery in the USA. METHODS Two cohorts of patients undergoing major non-cardiac surgery(More)
OBJECTIVES There is no up-to-date literature review of physiologically based, aggregate weighted 'track and trigger' systems (AWTTS) and few data on their predictive ability for serious adverse outcomes. The aim of this study was to describe the AWTTS in clinical use and assess their ability to discriminate between survivors and non-survivors of hospital(More)
OBJECTIVES There is no up-to-date literature review of physiologically-based, single-parameter weighted "track and trigger" systems (SPTTS) and little data on their sensitivity and specificity to predict adverse outcomes. The aim of this study was to describe the SPTTS in clinical use and measure their sensitivity and specificity when using admission vital(More)