摘要
【目的】探讨POSSUM、P-POSSUM、Cr-POSSUM及APGBI4种评分系统预测结直肠癌手术风险的效果。【方法】应用POSSUM、P-POSSUM、Cr-POSSUM及APGBI评分系统对2005年7月至2010年3月中山大学附属第三医院胃肠外科行手术治疗的320例结直肠癌患者进行评分分析,预测手术并发症发生率和死亡率,同时绘制各评分系统预测并发症和死亡率的ROC曲线。【结果】POSSUM评分系统预测并发症的发生率(126例、39.4%)及死亡率(32例、10%)分别显著高于实际并发症率(82例、25.6%,P<0.01)及死亡率(9例、2.8%,P<0.01),但老年患者的并发症预测发生率与实际发生率无统计学差异,其C-Index为0.767,最佳临界值为45%。P-POSSUM、Cr-POSSUM及APGBI评分系统预测死亡率(分别为12例、3.8%,13例、4.1%及14例、4.4%)与实际死亡率(9例、2.8%)无统计学差异,其C-Index分别为0.872、0.906及0.936,最佳临界值分别为7%、5%及4%。【结论】POSSUM评分系统能较准确地预测高危结直肠癌手术患者的并发症发生率,但过高预测死亡率,P-POSSUM、Cr-POSSUM及APGBI评分系统均能准确预测结直肠癌患者手术死亡率。
[Objective] To evaluate the effect of POSSUM,P-POSSUM,Cr-POSSUM,and APGBI scoring systems in predicting risk of colorectal cancer resection.[Methods] Clinical data of 320 cases of patients accepting surgery on colorectal cancer from July 2005 to March 2010 in Gastrointestinal Department of the Third Affiliated Hospital of Sun Yet-Sen University were collected both pre-and intra-operatively.POSSUM,P-POSSUM,Cr-POSSUM and APGBI scoring systems were used to calculate scores and predict incidence of postoperative complications and mortality.Afterwards,ROC curves of predicted results were drawn.[Results] The predicted incidence of postoperative complications and mortality were 39.4% and 10% respectively estimated with POSSUM scoring system,which were higher than the actual ones（25.6% and 2.8% respectively,P 0.01）.While in the elderly group of patients,there was no difference in the incidence of postoperative complications between predicted result and the actual one.The area under curve was 0.767,and the most critical value was 45%.There was no difference in mortality among predicted results estimated with P-POSSUM（3.8%）,Cr-POSSUM（4.1%）,and APGBI（4.4%） scoring systems and the actual one.Respectively,the areas under curve were 0.872,0.906,and 0.936,and the most critical values were 7%,5% and 4%.[Conclusions] POSSUM scoring system was effective in estimating incidence of postoperative complications of high risk group of patients while it over estimated mortality.P-POSSUM,Cr-POSSUM,and APGBI scoring systems were all effective in estimating mortality.
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2011年第4期547-552,共6页
Journal of Sun Yat-Sen University:Medical Sciences
基金
广东省医学科学研究基金(B2010093)
