title: [Estimation of morbidity risk in aged patients undergoing resections of esophagus carcinoma and gastric cardiac carcinoma using physiological and operative severity score].
abstract: OBJECTIVE
  To test the clinical validity of physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) in aged patients undergoing resections of esophagus carcinoma and gastric cardiac carcinoma.
  
  
  METHODS
  POSSUM was used in 167 aged patients undergoing esophagus carcinoma and gastric cardiac carcinoma resection. The physiological score and the operative severity score were compared between the groups with and without postoperative complications. The morbidity rates were calculated. Observed morbidity rates were compared with the rates predicted by POSSUM.
  
  
  RESULTS
  Seventy-six of the 167 patients suffered from postoperative complications. The physiological score of the group with complications was 16.75 +/- 0.4, significantly higher than that of the group without complications (15.4 +/- 0.3, P < 0.0017). The number of the patients with complications predicted by POSSUM was 70, not significantly different from the observed number of the patients with complications (78, P = 0.378). There were 94 person-times of complications in these 78 patients, 12 being with hypertension, 37 with arrhythmia; 5 with asthma; 3 with febrile; 2 with pneumonia; 1 with atelectasis; 1 with respiratory failure; 3 with wound infection; 3 with wound liquefaction; 2 with anastomotic leakage; 6 with phlebitis; 2 with pneumothorax; 2 with acute dilatation of stomach; 1 with chylothorax; 2 with hemorrhage; 1 with cardiac failure; 1 with infectious shock; 2 with empyema; 2 with deep vein thrombo-embolism; 1 with pulmonary infarction; 1 with cerebral infarction; 1 with urinary infection; and 1 with psychiatric symptom.
  
  
  CONCLUSIONS
  The POSSUM makes satisfactory prediction of postoperative morbidity in aged patients undergoing esophagus carcinoma and gastric cardiac carcinoma resection. Intensive monitoring and organ supporting therapy after the operation according to the score is of great benefit to decrease the post-operative complications.
authors.affiliation: Department of Thoracic Surgery, Fourth Hospital Affiliated to Hebei Medical University, Shijiazhuang 050011, China.
authors.forename: Li-wei
authors.initials: LW
authors.lastname: Yang
authors.forename: Shi-xiang
authors.initials: SX
authors.lastname: Bai
authors.forename: Xian-li
authors.initials: XL
authors.lastname: Meng
authors.forename: Ming
authors.initials: M
authors.lastname: He
authors.forename: Qing-yi
authors.initials: QY
authors.lastname: Liu
authors.forename: Xin
authors.initials: X
authors.lastname: Chen
mesh_terms: D000368:Aged; D002299:Cardia; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008991:Monitoring, Physiologic; D011183:Postoperative Complications / Q000175:diagnosis* / Q000401:mortality; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*