中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2008年
4期
241-244
,共4页
任立焕%傅卫%王亮%李磊%张春%袁炯%王德臣%吕旌乔%张同琳
任立煥%傅衛%王亮%李磊%張春%袁炯%王德臣%呂旌喬%張同琳
임립환%부위%왕량%리뢰%장춘%원형%왕덕신%려정교%장동림
结直肠肿瘤%死亡率%预测%手术后并发症
結直腸腫瘤%死亡率%預測%手術後併髮癥
결직장종류%사망솔%예측%수술후병발증
Colorectal neoplasms%Mortality%Forecasting%Postoperative complications
目的 比较并发症和病死率的生理和手术严重性评分(physiological and operative severity score for the enumeration of mortality and morbidity,POSSUM)、并发症和病死率的生理和手术严重性评分(Portsmouth POSSUM,P-POSSUM)、结直肠切除的并发症和病死率的生理和手术严重性评分(colorectal POSSUM,Cr-POSSUM)对结直肠癌患者住院期间病死率的预测能力.方法 调查北京大学第三医院1992-2005年903例结直肠癌外科手术切除的资料.903例中,结肠癌518例,直肠癌385例.用ROC曲线分析判断评分的判别能力,用Hosmer-Lemeshow检验判断评分的拟合优度,用不同危险因素群的O∶E值判断评分的预测能力.结果 903例患者住院期间的病死率为1.0%(9/903).POSSUM、P-POSSUM、Cr-POSSUM预测的病死率分别为5.6%、2.8%、4.8%,三种评分预测的病死率明显高于实际的病死率,O:E值分别为0.18、0.35、0.2.结论 POSSUM、P-POSSUM和Cr-POSSUM在结直肠癌手术中预测的病死率高于实际病死率.
目的 比較併髮癥和病死率的生理和手術嚴重性評分(physiological and operative severity score for the enumeration of mortality and morbidity,POSSUM)、併髮癥和病死率的生理和手術嚴重性評分(Portsmouth POSSUM,P-POSSUM)、結直腸切除的併髮癥和病死率的生理和手術嚴重性評分(colorectal POSSUM,Cr-POSSUM)對結直腸癌患者住院期間病死率的預測能力.方法 調查北京大學第三醫院1992-2005年903例結直腸癌外科手術切除的資料.903例中,結腸癌518例,直腸癌385例.用ROC麯線分析判斷評分的判彆能力,用Hosmer-Lemeshow檢驗判斷評分的擬閤優度,用不同危險因素群的O∶E值判斷評分的預測能力.結果 903例患者住院期間的病死率為1.0%(9/903).POSSUM、P-POSSUM、Cr-POSSUM預測的病死率分彆為5.6%、2.8%、4.8%,三種評分預測的病死率明顯高于實際的病死率,O:E值分彆為0.18、0.35、0.2.結論 POSSUM、P-POSSUM和Cr-POSSUM在結直腸癌手術中預測的病死率高于實際病死率.
목적 비교병발증화병사솔적생리화수술엄중성평분(physiological and operative severity score for the enumeration of mortality and morbidity,POSSUM)、병발증화병사솔적생리화수술엄중성평분(Portsmouth POSSUM,P-POSSUM)、결직장절제적병발증화병사솔적생리화수술엄중성평분(colorectal POSSUM,Cr-POSSUM)대결직장암환자주원기간병사솔적예측능력.방법 조사북경대학제삼의원1992-2005년903례결직장암외과수술절제적자료.903례중,결장암518례,직장암385례.용ROC곡선분석판단평분적판별능력,용Hosmer-Lemeshow검험판단평분적의합우도,용불동위험인소군적O∶E치판단평분적예측능력.결과 903례환자주원기간적병사솔위1.0%(9/903).POSSUM、P-POSSUM、Cr-POSSUM예측적병사솔분별위5.6%、2.8%、4.8%,삼충평분예측적병사솔명현고우실제적병사솔,O:E치분별위0.18、0.35、0.2.결론 POSSUM、P-POSSUM화Cr-POSSUM재결직장암수술중예측적병사솔고우실제병사솔.
objective To compare three risk prediction system,the physiological and operative severity score for the enumeration of mortality and morbidity(POSSUM),the Portsmouth POSSUM (P-POSSUM)and the colorectal POSSUM(Cr-POSSUM)for the accuracy in predicting operative mortality of patients of colorectal cancer in a single Chinese referral hospital setting. Methods Data of 903 patients,who undergone surgery for colon and rectal cancers from 1992 to 2005 at Peking University Third Hospital,were enrolled in the study.POSSUM,P-POSSUM and Cr-POSSUM was used respectively to predict the mortality rate.ROC curve was applied to judge the differentiation ability of each score.Model goodness-or-fit was tested by the Hosmer-Lemeshow statistic and subgroup analysis was performed by the ratio of observed to expected deaths(O∶E ratio). Results The actual inhospital mortality in our series was 1.0%(9/903).The oredicted mortality rate by POSSUM,P-POSSUM and Cr-POSSUM were 5.6%,2.8% and 4.8%respectively.These predicted mortality rate were significantly higher than actual mortality of our patients.The O∶E ratio was 0.18,0.35 and 0.2 respectively. Conclusion The predicted mortality rate of POSSUM,P-POSSUM and Cr-POSSUM were significantly higher than actual observed mortality rate in a single Chinese referral hospital for patients of colorectal cancer.
