Elderly POSSUM, a dedicated score for prediction of mortality and morbidity after major colorectal surgery in older patients
| Autor: | H Levard, S Tezenas du Montcel, Jean Marie Hay, B Suc, Jean-Jacques Duron, B Descottes, B Desrousseaux, P Tran Ba Loc |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
Aged
80 and over medicine.medical_specialty Scoring system Receiver operating characteristic business.industry Reproducibility of Results Sensitivity and Specificity Severity of Illness Index Surgical risk Colorectal surgery Surgery Older patients Internal medicine Epidemiology Severity of illness medicine Humans In patient Hospital Mortality Colorectal Neoplasms business Aged |
| Zdroj: | British Journal of Surgery. 97:396-403 |
| ISSN: | 1365-2168 0007-1323 |
| DOI: | 10.1002/bjs.6903 |
| Popis: | BackgroundSeveral scores have been developed to evaluate surgical unit mortality and morbidity. The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) and derivatives use preoperative and intraoperative factors, whereas the Surgical Risk Scale (SRS) and Association Française de Chirurgie (AFC) score use four simple factors. To allow for advanced age in patients undergoing colorectal surgery, a dedicated score—the Elderly (E) POSSUM—has been developed and its accuracy compared with these scores.MethodsFrom 2002 to 2004, 1186 elderly patients, at least 65 years old, undergoing major colorectal surgery in France were enrolled. Accuracy was assessed by calculating the area under the receiver operating characteristic curve (AUC) (discrimination) and calibration.ResultsThe mortality and morbidity rates were 9 and 41 per cent respectively. The E-POSSUM had both a good discrimination (AUC = 0·86) and good calibration (P = 0·178) in predicting mortality and a reasonable discrimination (AUC = 0·77) and good calibration (P = 0·166) in predicting morbidity. The E-POSSUM was significantly better at predicting mortality and morbidity than the AFC score (Pc = 0·014 and Pc < 0·001 respectively).ConclusionThe E-POSSUM is a good tool for predicting mortality, and the only efficient scoring system for predicting morbidity after major colorectal surgery in the elderly. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text