POSSUM 评分系统对老年结直肠癌患者术后并发症和死亡率的预测价值。

Predictive value of POSSUM scoring system for postoperative complications and mortality in elderly patients with colorectal cancer.

出版信息

Technol Health Care. 2024;32(6):4653-4660. doi: 10.3233/THC-240849.

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11613136/

Abstract

BACKGROUND

The POSSUM scoring system, widely employed in assessing surgical risks, offers a simplified and objective approach for the prediction of complications and mortality in patient. Despite its effectiveness in various surgical fields, including orthopedics and cardiovascular surgery, yet its utilization in elderly patients undergoing colorectal cancer surgery is infrequent.

OBJECTIVE

To analyze the predictive value of POSSUM scoring system for postoperative complications and mortality in elderly with colorectal cancer.

METHODS

306 elderly colorectal cancer patients were grouped according to the complications and death within 30 days after surgery. Among them, 108 cases in complication group, 198 cases in non-complication group, 16 cases in death group and 290 cases in survival group. POSSUM scores of all subjects were obtained and its predictive value for postoperative complications and mortality of elderly was conducted by ROC curve.

RESULTS

No apparent difference were observed in complications and mortality among patients with different disease types, operation types and operation timing (P> 0.05). The R2 in complication group was higher than non-complication group (P< 0.05). The R1 in death group were higher than survival group (P< 0.05). The AUC of R2 for predicting postoperative complications was 0.955 with a sensitivity of 88.89% and a specificity of 94.44% and the AUC of R1 for evaluating postoperative mortality of elderly with colorectal cancer was 0.783 with a sensitivity of 56.25% and a specificity of 82.93%.

CONCLUSION

POSSUM score system has a certain predictive value for postoperative complications and mortality in elderly with colorectal cancer. However, the predicted mortality rate is higher than actual mortality rate.

摘要

背景

POSSUM 评分系统广泛应用于评估手术风险，为预测患者并发症和死亡率提供了简化和客观的方法。尽管它在包括骨科和心血管外科在内的多个外科领域都很有效，但在老年结直肠癌手术患者中的应用并不常见。

目的

分析 POSSUM 评分系统对老年结直肠癌患者术后并发症和死亡率的预测价值。

方法

根据术后 30 天内发生并发症和死亡的情况，将 306 例老年结直肠癌患者分为并发症组和无并发症组，死亡组和生存组。其中并发症组 108 例，无并发症组 198 例，死亡组 16 例，生存组 290 例。获得所有受试者的 POSSUM 评分，并通过 ROC 曲线分析其对老年患者术后并发症和死亡率的预测价值。

结果

不同疾病类型、手术类型和手术时机的患者并发症和死亡率无明显差异（P>0.05）。并发症组的 R2 高于无并发症组（P<0.05）。死亡组的 R1 高于生存组（P<0.05）。预测术后并发症的 R2 的 AUC 为 0.955，灵敏度为 88.89%，特异度为 94.44%；评估老年结直肠癌患者术后死亡率的 R1 的 AUC 为 0.783，灵敏度为 56.25%，特异度为 82.93%。