Comparison of P-POSSUM and Cr-POSSUM Scores in Patients Undergoing Colorectal Cancer Resection

Abstract

at our institution were enrolled in the study.Main Outcome Measures: P-POSSUM and Cr-POSSUM scores were calculated for each patient. Inhospital mortality rate and number of deaths within 30 days after surgery were recorded. The ratio of observed to expected deaths was calculated for each analysis.Results: The P-POSSUM system underpredicted mortality by 25%, with no significant difference between the predicted and observed values (P=.96). The observed to expected ratio for Cr-POSSUM was 1.11, with no significant difference between the observed and predicted values (P=.19). Area under the receiver operating curve for P-POSSUM was 0.70 and for Cr-POSSUM was 0.59.Conclusions: Both P-POSSUM and Cr-POSSUM perform well in predicting mortality after colorectal cancer surgery, but the Cr-POSSUM is more accurate. There is a constant need for reevaluation of existing and any new scoring systems outside original development and validation populations. The Cr-POSSUM score is a promising specialized tool for monitoring surgical outcomes in colorectal cancer surgery.

Evaluation of Modified Estimation of Physiologic Ability and Surgical Stress in Colorectal Carcinoma Surgery

“…The previous studies reported that AUCs of ACPGBI were 0.775 and 0.701 in colorectal carcinoma surgery, 7,8 which are similar to our data. AUCs of CR-POSSUM were reported to be 0.59 -0.69, 8,27 which seems to be lower than the current data (0.78). These models probably fail to achieve high discriminatory power by reducing the number of variables.…”

A Systematic Review of POSSUM and its Related Models as Predictors of Post-operative Mortality and Morbidity in Patients Undergoing Surgery for Colorectal Cancer

“…The majority of studies (14/19) reported death rates as 30-day mortality while four studies reported in-hospital rates. In the study 38 that reported both, the 30-day figure was used in the current review. (Table 3) The operative and pathological details of the study populations are summarised in Table 4.…”

Clinical risk scores to guide perioperative management

“…However, P-POSSUM has no morbidity prediction equation, as a result of the original authors' lack of confidence in the reporting of perioperative complications 59. Subsequent studies have shown P-POSSUM to both over-predict54 64 and under-predict mortality48 61 65 in different settings.…”