Can SAPS II predict operative mortality more accurately than POSSUM and P-POSSUM in patients with colorectal carcinoma undergoing resection?

World Journal of Surgery
Mehmet F CanSadettin Cetiner

Abstract

This study assessed the APACHE II (Acute Physiology and Chronic Health Evaluation II), SAPS II (Simplified Acute Physiology Score-II), POSSUM (Physiologic and Operative Severity Score for Enumeration of Morbidity and Mortality), and P-POSSUM (Portsmouth-POSSUM) in patients with colorectal cancer undergoing curative or palliative resection. Predicted mortality rates and the observed/expected mortality ratio were computed by means of each scoring system. The results were compared between survivors and nonsurvivors and between elective and emergency operations. Each model was assessed for its accuracy to predict the risk of death using receiver operator characteristic (ROC) curve analysis, and risk stratification was generated as well. Some 224 patients were enrolled in the study. The overall 30-day mortality rate was 3.6% (n = 8). Predicted mortality rates generated by APACHE II, SAPS II, POSSUM, and P-POSSUM were 9.1%, 3.7%, 13.4%, and 5.2%, respectively. All the scoring systems assigned higher scores to those patients who died than to those who survived. Areas under the curve calculated by ROC curve analysis for APACHE II, SAPS II, POSSUM, and P-POSSUM were 0.786, 0.854, 0.793, and 0.831, respectively. Best stratification was a...Continue Reading

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Citations

Sep 9, 2010·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Colin Hewitt RichardsDonald C McMillan
Oct 12, 2010·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Pascal H E TeeuwenR P Bleichrodt
Mar 10, 2012·World Journal of Surgery·Christopher C ThornRichard A Harrison
May 21, 2011·Lancet·James M KinrossJeremy K Nicholson
Aug 30, 2008·American Journal of Surgery·Mehmet Fatih Can, Gokhan Yagci
Sep 24, 2010·Journal of Evaluation in Clinical Practice·Yasser SakrKonrad Reinhart
Feb 11, 2014·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·F J van der SluisA F Engel
Jun 1, 2016·Surgery Today·Laura LorenzonGenoveffa Balducci

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