Carvalho-E-Carvalho Maria Emília, DE-Queiroz Fábio Lopes, Martins-DA-Costa Breno Xaia, Werneck-Côrtes Marcelo Giusti, Pires-Rodrigues Vinícius
Coloproctology Clinic, Felício Rocho Hospital, Belo Horizonte, MG, Brazil.
Rev Col Bras Cir. 2018;45(1):e1347. doi: 10.1590/0100-6991e-20181347. Epub 2018 Feb 15.
to apply the POSSUM and P-POSSUM scores as a tool to predict morbidity and mortality in colorectal surgery.
we conducted a prospective cohort study of 551 patients submitted to colorectal surgery in a colorectal surgery tertiary referral hospital in Brazil. We grouped patients into pre-established risk categories for comparison between expected and observed morbidity and mortality rates by the POSSUM and P-POSSUM scores.
in the POSSUM morbidity analysis, the overall expected morbidity was significantly higher than that observed (39.2% vs. 15.6%). The same occurred with patients grouped in categories II (28.9% x 10.5) and III (64.6% x 24.5%). In category I, the expected and observed morbidities were similar (13.7% x 9.1%). Regarding the evaluation of mortality, it was statistically higher than that observed in category III patients and in the total number of patients (11.3% vs. 5.6%). In categories I and II, we observed the same pattern of category III, but without statistical significance. When evaluating mortality by the P-POSSUM score, the overall expected and observed mortality was similar (5.8% x 5.6%). Of the 31 patients who died, 20.2% underwent emergency procedures and sepsis was the main cause of death.
the P-POSSUM score was an accurate tool to predict mortality and could be safely used in this population profile, unlike the POSSUM score.
应用POSSUM和P-POSSUM评分作为预测结直肠手术发病率和死亡率的工具。
我们在巴西一家结直肠手术三级转诊医院对551例行结直肠手术的患者进行了一项前瞻性队列研究。我们将患者分为预先设定的风险类别，以通过POSSUM和P-POSSUM评分比较预期和观察到的发病率及死亡率。
在POSSUM发病率分析中，总体预期发病率显著高于观察到的发病率（39.2%对15.6%）。在II类（28.9%对10.5%）和III类（64.6%对24.5%）分组的患者中也出现了同样情况。在I类中，预期发病率和观察到的发病率相似（13.7%对9.1%）。关于死亡率评估，在III类患者和患者总数中，预期死亡率在统计学上高于观察到的死亡率（11.3%对5.6%）。在I类和II类中，我们观察到与III类相同的模式，但无统计学意义。当通过P-POSSUM评分评估死亡率时，总体预期死亡率和观察到的死亡率相似（5.8%对5.6%）。在31例死亡患者中，20.2%接受了急诊手术，败血症是主要死亡原因。
与POSSUM评分不同，P-POSSUM评分是预测死亡率的准确工具，可安全用于该人群。
