Prospective evaluation of in-hospital mortality with the P-POSSUM scoring system in patients undergoing major digestive surgery.

Background: The P-POSSUM score, the most well known of predictive scores for postoperative mortality, requires validation for population and setting.

Methods: Validation methods included discrimination (C-index statistic), observed:expected (O:E) ratio, calibration with the Hosmer-Lemeshow test, and subgroup analysis (emergency surgery, cancer, age, organs). The study included 3,881 multisite patients undergoing major digestive surgery in France.