POSSUM评分系统预测高龄食管胃结合部腺癌术后并发症风险的临床应用研究

Clinical Application of POSSUM Scoring System in Evaluating Postoperative Complications of Elderly Patients with Adenocarcinoma of the Esophagogastric Junction

目的应用死亡率和并发症发生率的生理学和手术严重度评分系统(POSSUM评分系统)预测高龄食管胃结合部腺癌患者术后并发症概率,探讨POSSUM评分系统预测高龄食管胃结合部腺癌术后并发症风险的能力。方法选择我院98例高龄食管胃结合部腺癌手术患者,用POSSUM评分系统预测其术后并发症发生率并绘制受试者工作特征曲线(ROC曲线)。结果 98例患者术后发生并发症26例,并发症组的术前生理学评分、手术严重度评分及预测并发症概率均高于无并发症组,差异均有统计学意义(P<0.05),ROC曲线下面积为0.844。结论术前生理学评分、手术严重度评分增高者发生术后并发症概率高,POSSUM评分系统预测高龄食管胃结合部腺癌术后并发症风险的能力为中等,有实际临床应用价值。

Objective To explore the feasibility of POSSUM scoring system in predict the postoperative complications in the elderly patients with adenoearcinoma of the esophagogastric junction （AEGJ）. Methods Totally 98 elderly AEGJ patients were scored with POSSUM scoring system and their clinical data were retrospectively analzyed. Results Of these 98 cases, 26 developed post -operative complications. The preoperative physiological score, severity score, and the predicted probability of complications are significantly higher in the complication group than in non - complication group （ P 〈 0.05 ） and the area under ROC curve was 0. 844. Conclusions The elderly patients with increased preoperative physiological score and operative severity score arc more likely to suffer from post - operative complications. The POSSUM scoring system has a moderate value in predic- ting post -operative complications and therefore can be clinically applied.