Document Detail


Perioperative outcome of colorectal cancer and validation of CR-POSSUM in a Caribbean country.
MedLine Citation:
PMID:  19737634     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the risk-adjusted perioperative outcome of colorectal cancer surgery, applying the Colorectal Physiological and Operative Severity Score for the enumeration of Mortality and morbidity (CR-POSSUM). METHODS: A retrospective chart review of patients who underwent colorectal cancer surgery from 2004 to 2007 was done. Data including demographics and physiological data for CR-POSSUM were recorded. Predicted mortality was calculated; validation of CR-POSSUM was done using Hosmer-Lemeshow goodness-of-fit and Receiver Operating Characteristic (ROC) Curve analyses. RESULTS: 232 patients were studied. The overall mean CR-POSSUM score was 18.3+/-3.8 (SD). Predicted mortality was 7.7%, observed mortality was 6.9% and the standardized mortality ratio was 0.9. 34.4% of patients presented with Duke's Stage C or D and had a higher risk of mortality (Odds Ratio (OR) 3.1, 95% Confidence Intervals (CI) 1.1, 9.1). Emergency surgery was associated with a higher risk of mortality (OR 4.7, 95% CI 1.5, 14.1). CR-POSSUM calibrated well (Hosmer-Lemeshow Chi-square value 4.3; df: 8; p=0.82) and fairly discriminated outcome as shown by the area under the ROC Curve 0.69, (Standard Error: 0.07). CONCLUSIONS: Perioperative outcome of colorectal surgery in Trinidad and Tobago is comparable to the developed countries as evaluated by the CR-POSSUM. Patients presenting for emergency surgery and those with advanced stages of cancer had higher perioperative mortality.
Authors:
Seetharaman Hariharan; Deryk Chen; Anushka Ramkissoon; Nicholas Taklalsingh; Chevonne Bodkyn; Ryon Cupidore; Amit Ramdin; Akash Ramsaroop; Videsh Sinanan; Siara Teelucksingh; Sumit Verma
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Publication Detail:
Type:  Journal Article     Date:  2009-09-06
Journal Detail:
Title:  International journal of surgery (London, England)     Volume:  7     ISSN:  1743-9159     ISO Abbreviation:  -     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101228232     Medline TA:  Int J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  534-8     Citation Subset:  IM    
Affiliation:
Department of Clinical Surgical Sciences, The University of the West Indies, St. Augustine, Eric Williams Medical Sciences Complex, Mount Hope, Trinidad and Tobago. uwi.hariharan@gmail.com
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