Analysis of POSSUM score and postoperative morbidity in patients with rectal cancer undergoing surgery
Analysis of POSSUM score and postoperative morbidity in patients with rectal cancer undergoing surgery
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DOI：
10.1007/s00423-008-0314-6
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发表时间：
2009-01-01
影响因子：
2.3
通讯作者：
Alvarez Cienfuegos, J.
中科院分区：
文献类型：
--
作者：
Valenti, V.;Hernandez-Lizoain, J. L.;Alvarez Cienfuegos, J.
死亡率和发病率的生理和手术严重程度评分（POSSUM）和后来的修改（P-POSSUM y CR-POSSUM）已被用于预测直肠癌手术患者的发病率和死亡率。然而，这些计算需要一些调整。本研究的目的是评估POSSUM对一组直肠癌手术患者的适用性，通过几个变量分析手术发病率。方法1995年1月至2004年12月，273例直肠癌患者连续行手术治疗。收集有关患者、肿瘤和治疗的信息。为了评估POSSUM的预测能力，根据与手术发病率和死亡率相关的变量创建亚组进行分析。结果全球发病率为23.6% （POSSUM预测为31.2%）。死亡率为0.7% （POSSUM、P-POSSUM和CR-POSSUM预测分别为6.64、1.95和2.08）。对于年龄小于51岁、年龄大于70岁、麻醉风险低（ASA I/II）、DUKES分期C和D期、手术时间小于180分钟以及接受新辅助治疗的患者，possum预测可能更准确。结论POSSUM是一个很好的工具，可以使不同机构和出版物之间的结果具有可比性。我们发现与明日性相关的一些变量存在预测误差。修改手术变量和新辅助治疗规范，以及包括生活方式在内的生理变量，可能会改善手术风险的未来预测。需要更多的研究来进一步确定手术并发症的潜在危险因素。
Background The Physiological and Operative Severity Score for the enumeration of Mortality andmorbidity (POSSUM) and later modifications (P-POSSUM y CR-POSSUM) have been used to predictmorbidity and mortality rates among patients with rectal cancer undergoing surgery. These calculations needsome adjustment, however. The aim of this study was to assess the applicability of POSSUM to a group of patients with rectal cancer undergoing surgery, analysing surgical morbidity by means of several variables.Methods between January 1995 and December 2004, 273 consecutive patients underwent surgery forrectal cancer. Information was gathered about the patients, tumour andtherapy. To assess the predictioncapacity of POSSUM, subgroups for analysis were created according to variables related to operativemorbidity and mortality.Results The global morbidity rate was 23.6% (31.2% predicted by POSSUM). The mortality rate was 0.7% (6.64, 1.95 and 2.08 predicted by POSSUM, P-POSSUM and CR-POSSUM respectively). POSSUMpredictions may be more accurate for patients younger than 51 years, older than 70 years, with low anaesthetic risk (ASA I/II), DUKES stage C and D, surgery duration of less than 180 minutes and for thosereceiving neoadjuvant therapy.Conclusion POSSUM is a good instrument to make results between different institutions and publicationcomparable. We found prediction errors for some variables related tomorbidity. Modifications of surgicalvariables and specifications for neoadjuvant therapy as well as physiological variables including life stylemay improve future prediction of surgical risk. More research is needed to identify further potential riskfactors for surgical complications.