Surgical Evaluation of P-Possum and Cr-Possum Scores in Patient Undergoing Colorectal Cancer Operation

Journal of National Institute of Neurosciences Bangladesh Pub Date : 2020-12-14 DOI:10.3329/jninb.v6i2.50767

S. Alam, Ayesha Rahman, A. Ahmed, M. Haque, Nazia Mehnaz Joty, A. Talukder

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Abstract

Background: "Portsmouth" modification of POSSUM (P-POSSUM) scoring system used to assess mortality in general surgical patients and “Colorectal” Cr-POSSUM scoring system used for mortality assessment for colorectal patient. Objective: The purpose of the present study was to estimate the validity of the P-POSSUM (Portsmouth-POSSUM) and Cr-POSSUM (Colorectal-POSSUM) score in predicting the risk of mortality in colorectal cancer patient. Methodology: This was single centre clinical trial was carried out in the Department of Surgery at Dhaka Medical College Hospital, Dhaka, Bangladesh from November 2013 to April 2014 for a period of six (06) months. Patients of both sex who got admitted in the surgery in-patient department for elective colorectal cancer operations were selected as study population. Both the P-POSSUM and Cr-POSSUM, physiological score, operative score, predicted mortality rate were calculated using an online POSSUM calculator. Based on both P-POSSUM and Cr-POSSUM Scoring, patients were categorized into three risk groups. Then a comparative analysis was performed between the observed and the predicted values as well as the Observed/Predicted ratio (O:P) in all the risk groups. Results: A total of 50 patients with the median age of 50 (ranging 20 to 72) years were studied. 30 days overall observed mortality was 3(6%) patients. The mean P-POSSUM and C-POSSUM physiological scores were 32.49±2.08 and 13.92±1.30 respectively. However, the operative score was 11.59±1.46 and 8.12±0.24 in P-POSSUM and C-POSSUM respectively. The overall mortality predicted by the P-POSSUM model was 5 patients (19.33±2.87) and mortality predicted by the Cr-POSSUM model was 4 patients (20.66±4.09). Conclusion: In conclusion both model accurately predicted the risk of postoperative death. Cr-POSSUM provided a better fit to observed results than P-POSSUM. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 118-123

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结直肠癌手术患者p -负鼠和cr -负鼠评分的外科评价

背景:“Portsmouth”改良POSSUM (P-POSSUM)评分系统用于评估普外科患者的死亡率，“Colorectal”Cr-POSSUM评分系统用于评估结直肠患者的死亡率。目的:本研究的目的是评估P-POSSUM (Portsmouth-POSSUM)和Cr-POSSUM(结肠直肠- possum)评分在预测结直肠癌患者死亡风险方面的有效性。方法:本研究为单中心临床试验，于2013年11月至2014年4月在孟加拉国达卡达卡医学院附属医院外科进行，为期6(06)个月。选择在外科住院部接受择期结直肠癌手术的男女患者作为研究人群。使用在线POSSUM计算器计算P-POSSUM和Cr-POSSUM、生理评分、手术评分、预测死亡率。根据P-POSSUM和Cr-POSSUM评分，将患者分为三个风险组。然后比较分析各危险组的观察值与预测值以及观察/预测比(O:P)。结果:共纳入50例患者，中位年龄50岁(20 ~ 72岁)。30天总观察死亡率为3例(6%)。P-POSSUM和C-POSSUM生理评分平均值分别为32.49±2.08和13.92±1.30。P-POSSUM和C-POSSUM的手术评分分别为11.59±1.46和8.12±0.24。P-POSSUM模型预测总死亡率为5例(19.33±2.87)，Cr-POSSUM模型预测总死亡率为4例(20.66±4.09)。结论:两种模型均能准确预测术后死亡风险。Cr-POSSUM比P-POSSUM更符合观察结果。孟加拉国国家神经科学研究所学报，2020;6(2):118-123

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Journal of National Institute of Neurosciences Bangladesh

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