Avaliação do risco cirúrgico nos doentes com cancro colo-rectal: POSSUM ou ACPGBI

• Author(s): Goulart, A ; Martins, S
• Date: 2013
• Persistent ID: http://hdl.handle.net/10400.23/525
• Origin: Repositório Científico do Hospital de Braga
• Subject(s): Neoplasias Colorrectais; Procedimentos Cirúrgicos do Sistema Digestivo; Indicadores de Saúde; Avaliação do Risco
• Document Type: Article
• Language: Portuguese

Description

Introduction: Several models have been developed with the purpose of predicting surgical risk of patients submitted to colorectal cancer surgery. However, to date, there isn’t any model that fulfills this purpose in a satisfactory manner. Methods: We consulted the clinical processes of 345 patients, who were submitted to surgical colorectal cancer treatment at the General Surgery department in Hospital de Braga, and calculated surgical risk based on the following risk assessment scales: Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity (POSSUM), Portsmouth POSSUM (P-POSSUM), ColoRectal POSSUM (CR-POSSUM), Association of Coloproctology of Great Britain and Ireland (ACPGBI) and modified ACPGBI. For all scales, we compared observed and previewed mortality and calculated Receiver Operating Characteristic (ROC) curve. Results and conclusion:The study included 345 patients submitted to colorectal cancer surgery of which 219 were male and 126 were female, with an average age of 68 years old. Most patients (69,0%) presented with colon cancer and 86,4% were submitted to elective surgery. Post-operatory mortality at 30 days was 3,768%. In the present study, despite no model being statistically better than the other, the ACPGBI model was the one that showed more discriminative properties which, along with easier applicability, makes it the best model for evaluating surgical risk in our population.