Comparison of POSSUM, P-POSSUM and Thoracoscore in forecast of the postoperative mortality in thoracic surgery patients
10.3760/cma.j.issn.1001-4497.2016.02.009
- VernacularTitle:POSSUM、P-POSSUM 及 Thoracoscore 预测胸外科患者术后病死率的评价比较
- Author:
Man YE
;
Yingxia LI
;
Fenglei YU
;
Jingping ZHANG
- Publication Type:Journal Article
- Keywords:
Risk assessment;
Thoracic surgical procedures;
Mortality
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2016;32(2):99-103
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate and compare the applicability and accuracy of POSSUM , P-POSSUM and Thora-coscore in predicting the postoperative mortality of thoracic surgery patients .Methods We collected the clinical data of 1 450 thoracic surgery patients during March 2012 to August 2013 in the Second Xiangya Hospital.We used the 3 kinds of risk sco-ring system to calculate the predicted postoperative mortality in these patients .Then we used H-L test and the area under the ROC curve to evaluate and compare their degrees of compliance and validities of identification independently .Results Within 1 450 cases,20 patients (1.4%) died in 30 days after surgery, POSSUM overestimated the mortality (3.84%,P<0.001), while the P-POSSUM (1.05%/1.10%) and Thoracoscore (0.90%) underestimated the mortality, P>0.05.The area under the ROC curve of POSSUM, P-POSSUM ( two kinds of death prediction formula ) and Thoracoscore to predict postoperative mortality in all thoracic surgery patients was 0.774,0.777,0.777 and 0.831 independently, P <0.05; the area under the ROC curve to predict postoperative mortality in patients after lung surgery was 0.755,0.771,0.771,0.849 independently, P<0.05; the area under the ROC curve to predict postoperative mortality of patients with esophageal surgery was 0.640,0.650,0. 650,0.764 independently, only Thoracoscore P<0.05;the area under the ROC curve to predict postoperative mortality of pa-tients with mediastinal and other surgical was 1.000,1.000,1.000,0.854 independently, only Thoracoscore P<0.05.Con-clusion Thoracoscore scoring system is the most suitable risk scoring system to predict postoperative mortality in thoracic sur-gery patients with high predictive accuracy and good identification validity .