Evaluation of the POSSUM, p-POSSUM, o-POSSUM, and APACHE II scoring systems in predicting postoperative mortality and morbidity in gastric cancer patients.
BACKGROUND/OBJECTIVE
Gastric cancer is the fourth most prevalent cancer worldwide. The ability to accurately predict surgery-related morbidity and mortality is critical in deciding both the timing of surgery and choice of surgical procedure. The aim of this study is to compare the POSSUM, p-POSSUM, o-POSSUM, and APACHE II scoring systems for predicting surgical morbidity and mortality in Chinese gastric cancer patients, as well as to create new scoring systems to achieve better prediction.


METHODS
Data from 612 gastric cancer patients undergoing gastrectomy between January 2007 and December 2011 were included in this study. The predictive abilities of the four scoring systems were compared by examining observed-to-expected (O/E) ratios, the receiver operating characteristic curve, Student t test, and χ2 test results.


RESULTS
The observed complication rate of 34% (n = 208) did not differ significantly from the rate of 36.6% (n = 208) predicted by the POSSUM scoring system (O/E ratio = 0.93). The observed mortality rate was 2.9% (n = 18). For predicting mortality, POSSUM had an O/E ratio of 0.34 as compared with p-POSSUM (O/E ratio = 0.91), o-POSSUM (O/E ratio = 1.26), and APACHE II (O/E ratio = 0.28).


CONCLUSION
The POSSUM scoring system performed well with respect to predicting morbidity risk following gastric cancer resection. For predicting postoperative mortality, p-POSSUM and o-POSSUM exhibited superior performance relative to POSSUM and APACHE II.
['Hong|Shikai|S|', 'Wang|Shengying|S|', 'Xu|Guozeng|G|', 'Liu|JinLu|J|']
D018806:APACHE D000328:Adult D000368:Aged D019540:Area Under Curve D002423:Cause of Death D002681:China D015331:Cohort Studies D005260:Female D005743:Gastrectomy D006305:Health Status Indicators D006785:Hospitals, University D006801:Humans D008297:Male D008875:Middle Aged D011183:Postoperative Complications D011237:Predictive Value of Tests D012372:ROC Curve D012189:Retrospective Studies D012720:Severity of Illness Index D013274:Stomach Neoplasms D016019:Survival Analysis D055815:Young Adult
scoring systems mortality morbidity gastric cancer receiver operating characteristic curve