Perioperative outcome of colorectal cancer and validation of CR-POSSUM in a Caribbean country
International journal of surgery
; 7(6): 534-538, Sep. 2009. tab, graf
Article
in English
| MedCarib
| ID: med-17696
Responsible library:
TT5
ABSTRACT
OBJECTIVE:
To evaluate the risk-adjusted perioperative outcome of colorectal cancer surgery, applying the Colorectal Physiological and Operative Severity Score for the enumeration of Mortality and morbidity (CR-POSSUM).METHODS:
A retrospective chart review of patients who underwent colorectal cancer surgery from 2004 to 2007 was done. Data including demographics and physiological data for CR-POSSUM were recorded. Predicted mortality was calculated; validation of CR-POSSUM was done using Hosmer-Lemeshow goodness-of-fit and Receiver Operating Characteristic (ROC) Curve analyses.RESULTS:
232 patients were studied. The overall mean CR-POSSUM score was 18.3+/-3.8 (SD). Predicted mortality was 7.7%, observed mortality was 6.9% and the standardized mortality ratio was 0.9. 34.4% of patients presented with Duke's Stage C or D and had a higher risk of mortality (Odds Ratio (OR) 3.1, 95% Confidence Intervals (CI) 1.1, 9.1). Emergency surgery was associated with a higher risk of mortality (OR 4.7, 95% CI 1.5, 14.1). CR-POSSUM calibrated well (Hosmer-Lemeshow Chi-square value 4.3; df 8; p=0.82) and fairly discriminated outcome as shown by the area under the ROC Curve 0.69, (Standard Error 0.07).CONCLUSIONS:
Perioperative outcome of colorectal surgery in Trinidad and Tobago is comparable to the developed countries as evaluated by the CR-POSSUM. Patients presenting for emergency surgery and those with advanced stages of cancer had higher perioperative mortality.
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Collection:
International databases
Database:
MedCarib
Main subject:
Trinidad and Tobago
/
Colorectal Neoplasms
/
Colorectal Surgery
/
Developing Countries
Type of study:
Prognostic study
Aspects:
Social determinants of health
Limits:
Female
/
Humans
/
Male
Country/Region as subject:
English Caribbean
/
Trinidad and Tobago
Language:
English
Journal:
International journal of surgery
Year:
2009
Document type:
Article
Institution/Affiliation country:
The University of the West Indies/Trinidad and Tobago