Document Detail


POSSUM is an optimal system for predicting mortality due to colorectal perforation.
MedLine Citation:
PMID:  18613381     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: The purpose of this study was to determine the most useful predictive scoring system for the postoperative mortality of patients with colorectal perforation using the Acute Physiological and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA) and Physiological and Operative Severity Score for the enUmeration of Mortality (POSSUM). METHODOLOGY: First, the 3 scoring systems were applied to all patients, and the efficacy of these systems was compared between survivors and non-survivors. Second, using receiver operating characteristic (ROC) curve analysis, optimal cut-off values were determined for each system and patients were divided into another two groups (high score group and low score group). Then statistical analyses were performed, respectively. RESULTS: All scoring systems gave significantly lower scores for survivors than for non-survivors. POSSUM was the most sensitive system for predicting operative mortality (POSSUM: sensitivity 87.5%). Kaplan-Meier analysis and log rank test revealed that there were significant differences between the high score group and the low score group, except for APACHE II. Multivariate logistic regression analysis revealed that only POSSUM was an independent predictor (odds ratio, 0.858; 95% C.I.; 0.736-1,000; p = 0.0498). CONCLUSIONS: POSSUM is an optimal predictor of mortality following emergency surgery for colorectal perforation.
Authors:
Mitsuru Ishizuka; Hitoshi Nagata; Kazutoshi Takagi; Toru Horie; Keiichi Kubota
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  55     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2008 Mar-Apr
Date Detail:
Created Date:  2008-07-10     Completed Date:  2008-12-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  430-3     Citation Subset:  IM    
Affiliation:
Department of Gastroenterological Surgery, Dokkyo University School of Medicine, Tochigi, Japan. mm-ishizuka@umin.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Colonic Diseases / mortality*
Female
Humans
Intestinal Perforation / mortality*
Male
Middle Aged
Prognosis
Rectal Diseases / mortality*
Retrospective Studies
Severity of Illness Index

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