Evaluation of O-POSSUM in predicting in-hospital mortality after resection for oesophageal cancer.
BACKGROUND
The aims of the present study were to validate the Physiological and Operative Severity Score for the enUmeration of Mortality adjusted for oesophagogastric surgery (O-POSSUM).


METHODS
Data on patients who underwent potentially curative oesophagectomy in a tertiary referral centre for adenocarcinoma or squamous cell carcinoma of the oesophagus were analysed. The in-hospital mortality predicted by O-POSSUM was compared with the actual value by linear analysis.


RESULTS
Twenty-four (3.6 per cent) of 663 patients died in hospital. The observed : predicted ratio for in-hospital mortality was 0.29. The model had a poor fit (P < 0.001). The area under the receiver-operator characteristic curve was 0.60 (95 per cent confidence interval 0.47 to 0.72); P = 0.113). O-POSSUM score was not related to the severity of complications.


CONCLUSIONS
O-POSSUM overpredicted in-hospital mortality threefold and could not identify patients at higher risk of death. O-POSSUM needs substantial modification before it can be used for comparison of treatment outcomes between centres.
Lagarde
S M
SM
Department of Surgery, Academic Medical Centre at the University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. s.lagarde@slaz.nl
Maris
A K D
AK
de Castro
S M M
SM
Busch
O R C
OR
Obertop
H
H
van Lanschot
J J B
JJ
D000230:Adenocarcinoma / Q000401:mortality* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000601:surgery; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000601:surgery; D016629:Esophagectomy / Q000401:mortality*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012720:Severity of Illness Index