title: [Prevention strategy of post-operative complications in elderly patients with colorectal cancer based on scoring systems].
abstract: OBJECTIVE
  To explore the risk factors and prevention strategies of post-operative complications in elderly patients with colorectal cancer.
  
  
  METHODS
  Data of 107 elderly patients (≥75 years) undergoing surgery for colorectal cancer were collected from January 2006 to December 2009 in the Department of Gastrointestinal Surgery, Peking University People's Hospital. POSSUM and E-POSSUM scoring systems were used to predict post-operative complications. ROC curve and observe/expect(O/E) were used to assess the validity of scoring systems. Logistic regression was used to evaluate the independent risk factors associated with post-operative complications of elderly patients with colorectal cancer.
  
  
  RESULTS
  The predictive  complication rates of E-POSSUM and POSSUM in elderly patients with colorectal cancer were 13.9%-86.6%(average, 32.7%) and 19.1%-99.1% (average, 55.5%). The predictive validity of E-POSSUM was better than POSSUM(AUC of ROC: 0.862 vs. 0.576, O/E: 0.771 vs. 0.454), the former was closer to the actual complication rate(25.2%, 27/107). Concurrent diabetes mellitus(P=0.019) and rectal lesion(P=0.005) were independent risk factors associated with surgery-related post-operative complications. Anastomotic leakage was the most common surgery-related post-operative complications. Chronic obstructive pulmonary disease(P=0.026), ASA score(P=0.025), intestinal obstruction(P=0.037) and perforation(P=0.001) were independent risk factors associated with non-surgery-related post-operative complications. Pulmonary infection was the most common non-surgery-related post-operative complication.
  
  
  CONCLUSIONS
  The application of E-POSSUM scoring system can provide more accurate prediction of post-operative complications in elderly patients undergoing surgery for colorectal cancer. Positive interventions should be taken for high-risk patients to prevent post-operative complications.
authors.affiliation: Department of Gastrointestinal Surgery, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Qu
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.forename: Zhan-long
authors.initials: ZL
authors.lastname: Shen
authors.forename: Ru-kai
authors.initials: RK
authors.lastname: Xiao
authors.forename: Zhi-dong
authors.initials: ZD
authors.lastname: Gao
authors.forename: Ying-jiang
authors.initials: YJ
authors.lastname: Ye
authors.forename: Shan
authors.initials: S
authors.lastname: Wang
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D012307:Risk Factors