Institute for Clinical Research, National Hospital Organization, Kumamoto Medical Center, Kumamoto, Japan.
Dis Colon Rectum. 2011 Oct;54(10):1293-300. doi: 10.1097/DCR.0b013e3182271a54.
We recently modified Estimation of Physiologic Ability and Surgical Stress, our prediction scoring system.
This study evaluated the usefulness of our modified version for colorectal carcinoma in comparison with existing models.
This investigation studied a multicenter cohort.
The study was conducted in regional referral hospitals in Japan.
Patients were included who underwent elective surgery for colorectal carcinoma.
Postoperative morbidity, mortality, and predicted mortality rates for original and modified Estimation of Physiologic Ability and Surgical Stress were investigated in 2388 patients in comparison with existing European models.
Among the models, the modified Estimation of Physiologic Ability and Surgical Stress demonstrated the highest discriminatory power in terms of in-hospital mortality (area under receiver operating characteristic curve: 0.84 for Estimation of Physiologic Ability and Surgical Stress, 0.87 for modified Estimation of Physiologic Ability and Surgical Stress, 0.84 for Portsmouth modification of POSSUM, 0.74 for ASA status-based model), as well as 30-day mortality (area under receiver operating characteristic curve: 0.82 for Estimation of Physiologic Ability and Surgical Stress, 0.84 for modified Estimation of Physiologic Ability and Surgical Stress, 0.81 for POSSUM, 0.78 for colorectal POSSUM, 0.76 for Association of Coloproctology of Great Britain and Ireland score). British models, in general, overpredicted postoperative mortality rates by more than 10 times.
The current study analyzed only the Japanese population treated in medium-volume centers.
Among the models, modified Estimation of Physiologic Ability and Surgical Stress was the most accurate in predicting postoperative mortality in colorectal carcinoma surgery. These findings should be validated in Western populations, because the Japanese population may differ from Western populations in terms of body shape or reserve capacity.
我们最近对生理能力和手术应激估计（我们的预测评分系统）进行了修改。
本研究评估了与现有模型相比，我们修改后的版本在结直肠癌中的有用性。
这项调查研究了一个多中心队列。
研究在日本的区域转诊医院进行。
纳入接受择期结直肠癌手术的患者。
比较 2388 例患者的术后发病率、死亡率和原始和改良生理能力和手术应激估计的预测死亡率，以及与现有欧洲模型。
在这些模型中，改良生理能力和手术应激估计在院内死亡率方面表现出最高的区分能力（接受者操作特征曲线下面积：生理能力和手术应激估计为 0.84，改良生理能力和手术应激估计为 0.87，Portsmouth POSSUM 改良版为 0.84，ASA 状态模型为 0.74），以及 30 天死亡率（接受者操作特征曲线下面积：生理能力和手术应激估计为 0.82，改良生理能力和手术应激估计为 0.84，POSSUM 为 0.81，结直肠 POSSUM 为 0.78，英国和爱尔兰结直肠外科学会评分）。英国模型通常高估术后死亡率超过 10 倍。
本研究仅分析了在中等容量中心治疗的日本人群。
在这些模型中，改良生理能力和手术应激估计在预测结直肠癌手术后的死亡率方面最为准确。这些发现应在西方人群中进行验证，因为日本人群在体型或储备能力方面可能与西方人群不同。
Zotero 插件