POSSUM and Its Related Models as Predictors of Postoperative Mortality and Morbidity in Patients Undergoing Surgery for Gastro-oesophageal Cancer: A Systematic Review
| Autor: | Donald C. McMillan, Paul G. Horgan, Sumanta Dutta |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Esophageal Neoplasms business.industry Cancer Middle Aged Vascular surgery medicine.disease Severity of Illness Index Abdominal aortic aneurysm Cardiac surgery Surgery Stomach Neoplasms Cardiothoracic surgery Area Under Curve Severity of illness Epidemiology medicine Humans business Digestive System Surgical Procedures Aged Abdominal surgery |
| Zdroj: | World Journal of Surgery. 34:2076-2082 |
| ISSN: | 1432-2323 0364-2313 |
| Popis: | Gastro-oesophageal surgery is associated with appreciable postoperative morbidity and mortality. POSSUM (Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity) and its related models P-POSSUM and O-POSSUM have been developed to predict such events in general surgery. The aim was to undertake the first systematic review of the use of these models in gastro-oesophageal surgery patients. An online database search was carried out from 1991 to December 2008. Twenty-two published studies in gastro-oesophageal cancer surgery were identified. Twelve studies were found not to address the above aim, leaving ten relevant publications for analysis. Pooled data from these studies showed the weighted observed-to-expected ratio (O/E) for postoperative mortality using POSSUM (n = 1189), P-POSSUM (n = 2314), and O-POSSUM (n = 1755) was 0.37, 0.83, and 0.51, respectively. The weighted O/E for morbidity using POSSUM (n = 1038) was 0.86. POSSUM and O-POSSUM most significantly overestimated postoperative mortality in gastro-oesophageal cancer patients. In contrast, P-POSSUM had the least overestimation and may be the most useful predictor of likely postoperative mortality in these patients. |
| Databáze: | OpenAIRE |
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