P-POSSUM for Outcomes After Abdominal Surgery

Postoperative complications after abdominal surgery can lead to prolonged recovery, intensive care admission, and death. The P-POSSUM score is a commonly used surgical risk prediction tool, but its performance may vary between hospitals and patient populations. Frailty, especially in older patients, may also affect postoperative outcomes and may improve risk prediction when added to existing scoring systems. This ambispective observational cohort study evaluates the prognostic value of the P-POSSUM score, with additional assessment of frailty and routine perioperative clinical data, for predicting postoperative complications and treatment outcomes in adult patients undergoing abdominal surgery at Bach Mai Hospital. The study includes retrospective data from January 2025 and prospective data collection through May 2026. No intervention is assigned by the investigators. All patients receive routine perioperative care according to clinical practice. The study will assess the predictive performance of P-POSSUM for postoperative complications and mortality, and will explore whether adding frailty-related variables improves risk prediction.

Inclusion Criteria: Patients aged 60 years or older. Patients undergoing abdominal surgery at Bach Mai Hospital. Patients managed perioperatively or postoperatively by the Center for Anesthesia and Surgical Intensive Care. Patients with available perioperative clinical data required to calculate the P-POSSUM score. Patients with available baseline clinical, comorbidity, or functional status information for frailty assessment. Patients with available postoperative outcome data for assessment of complications, mortality, or treatment outcomes. Exclusion Criteria: Patients younger than 60 years. Patients not undergoing abdominal surgery. Patients undergoing minor procedures without operative severity data required for P-POSSUM calculation. Patients with missing key physiological or operative variables required to calculate the P-POSSUM score. Patients with insufficient baseline information for frailty assessment. Patients with insufficient postoperative follow-up data for outcome assessment.