Crea Nicola, Di Fabio Francesco, Pata Giacomo, Nascimbeni Riccardo
Cattedra di Chirurgia Generale, Università degli Studi di Brescia, Italy.
Ann Ital Chir. 2009 May-Jun;80(3):177-81.
This study was designed to assess the role of the ASA, POSSUM and APACHE II score systems for predicting the complications in patients undergoing surgery for colorectal diseases.
We retrospectively analyzed 539 patients undergoing colorectal surgery between January 1996 and December 2006. The accuracy of ASA, POSSUM and APACHE II score systems for predicting perioperative complications has been analysed.
Total postoperative morbidity was 15%, overall perioperative mortality was 1.5%. APACHE II and POSSUM predicted with the same accuracy the perioperative complications (0.65 and 0.68, respectively), while ASA score system revealed a poorer predicting accuracy (0.56). POSSUM predicted death rate more accurately compared to the APACHE II classification (1.6% vs. 10.4%).
APACHE II and POSSUM score systems may be useful tools helping surgeons to identify patient groups at high risk for complications. The ASA classification resulted less accurate, probably because related to the anesthesiologist's knowledge.
本研究旨在评估美国麻醉医师协会（ASA）评分系统、手术应激评分系统（POSSUM）和急性生理与慢性健康状况评分系统（APACHE II）在预测结直肠疾病手术患者并发症方面的作用。
我们回顾性分析了1996年1月至2006年12月期间接受结直肠手术的539例患者。分析了ASA、POSSUM和APACHE II评分系统预测围手术期并发症的准确性。
术后总发病率为15%，围手术期总死亡率为1.5%。APACHE II和POSSUM预测围手术期并发症的准确性相同（分别为0.65和0.68），而ASA评分系统的预测准确性较差（0.56）。与APACHE II分类相比，POSSUM预测死亡率更准确（1.6%对10.4%）。
APACHE II和POSSUM评分系统可能是帮助外科医生识别并发症高风险患者群体的有用工具。ASA分类的准确性较低，可能是因为与麻醉医生的知识有关。
