Comparison of outcome of POSSUM, p-POSSUM, and cr-POSSUM scoring after elective resection of the sigmoid colon for carcinoma or complicated diverticular disease.
Scand J Gastroenterol
; 42(7): 841-7, 2007 Jul.
Article
en En
| MEDLINE
| ID: mdl-17558908
ABSTRACT
OBJECTIVE:
To compare POSSUM, p-POSSUM, and cr-POSSUM-predicted mortalities with the observed postoperative mortality in patients undergoing elective sigmoid colectomy for diverticular disease (n=121) or carcinoma (n=120). MATERIAL ANDMETHODS:
The physiologic and operative severity score for the enumeration of mortality and morbidity (POSSUM) was used to identify patient- or disease-related risk factors and to calculate expected mortalities.RESULTS:
Patients with carcinoma had significantly higher POSSUM scores, but the observed mortality (1.7%) was lower than that in the diverticular disease group (3.3%). In the carcinoma group, mortality was over-predicted by all the POSSUM systems. In diverticular disease, POSSUM over-predicted mortality while p-POSSUM and cr-POSSUM under-predicted mortality. In the whole group, POSSUM over-predicted mortality. P-POSSUM and cr-POSSUM predicted mortality accurately observedexpected (OE) ratio 0.83. Replacing the score for malignancy with a minimum score of 1 gave overall OE ratios of 0.37 (POSSUM), 1.04 (p-POSSUM), and 0.93 (cr-POSSUM).CONCLUSIONS:
In a group of patients who underwent elective resection of the sigmoid colon for carcinoma or diverticular disease, postoperative mortality was predicted accurately by p-Possum and cr-POSSUM, especially when used without a score for malignancy. None of the POSSUM scores were predictive of disease-specific mortality.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias del Colon Sigmoide
/
Colon Sigmoide
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Carcinoma
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Cirugía Colorrectal
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Diverticulosis del Colon
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
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Aged
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Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Scand J Gastroenterol
Año:
2007
Tipo del documento:
Article
País de afiliación:
Países Bajos