Why the study?
Does the POSSUM score accurately predict postoperative complications in elderly patients undergoing surgery for colorectal cancer?
Does the POSSUM score accurately predict postoperative complications in elderly patients undergoing surgery for colorectal cancer?
The POSSUM score is a useful tool for predicting postoperative complications and guiding the selection of operative procedures in elderly patients with colorectal cancer.
POSSUM distinguished complication risk in this elderly colorectal cancer cohort; supports further validation before guiding operative decisions.
術後合併症発生のリスクファクターを定量化し,周術期管理の参考にするため, physiological and operative severity score for the enUmeration of mortality and morbidity; POSSUM score1)の有用性について検討した.対象は,過去10年間に経験した80歳以上の大腸癌67例中,手術を施行した63例とした.これらのphysiological score (PS)は22.5±5.4点と高値であり, 56例(88.9%)に併存疾患を認めた.術後合併症の発生頻度は46.0%であり,術後合併症発生例のPSは24.5±1.1点, operative severity score (OSS)は15.3±0.8点であった.これらから算定したmorbidity rateは68.1±3.4% (cut-off値は55%)であり,合併症非発生例よりも有意に高値であった(p<0.01).郭清度別の平均出血量を加味すると, Stage IIIでのOSSの最低点は結腸癌で13点,直腸癌で19点と想定され, morbidity rateが55%以下となるには, PSが結腸癌で22点,直腸癌では15点以下となる.このような良好なPSであれば,合併症を起こすことなく,根治術が可能であると考えられた.
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Hasegawa et al. (2001) studied this question.
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