title: Comparison of different scoring systems in patients undergoing colorectal cancer surgery for predicting mortality and morbidity.
abstract: BACKGROUND
  Preoperative risk estimation evaluating mortality and morbidity might help surgical decision.
  
  
  OBJECTIVE
  The aim of this study was to compare the sensitivities of physiologic and operative severity score for the enumeration of mortality and morbidity (POSSUM), portsmouth-POSSUM (P-POSSUM), colorectal-POSSUM (CR-POSSUM), the Association of Coloproctology of Great Britain and Ireland colorectal cancer model (ACPGBI CRC) and revised ACPGBI CRC scoring systems that are used for evaluating mortality and morbidity in colorectal surgery performed in third-level healthcare centers.
  
  
  METHODS
  A retrospective analysis has been performed on 335 consecutive patients undergoing colorectal cancer surgery between 2002 and 2012.
  
  
  METHODS
  Mortality and morbidity risks of 335 patients who underwent colorectal cancer were evaluated using these scoring systems and the results were compared with actual mortality and morbidity within postoperative 30-day that extend the duration of hospital stay.
  
  
  METHODS
  The receiver operating characteristic (ROC) curves were designed to identify the score values.
  
  
  RESULTS
  Results of POSSUM and P-POSSUM systems showed statistical differences compared with those of CR-POSSUM, ACPGBI CRC and revised ACPGBI CRC systems (P < 0.05). P-POSSUM was found to be the best scoring system for predicting mortality risk, although all scoring systems seem to be appropriate for this parameter. On the other hand POSSUM, which can predict morbidity, was found to have moderate differentiation ability due to the magnitude of the area under the ROC curve.
  
  
  CONCLUSIONS
  Despite altering patient demographics and surgical conditions, POSSUM seems to lead as the best scoring system for predicting mortality and morbidity among others including those most-recently proposed.
authors: F
authors: F
authors: Cengiz
authors: Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
authors: E
authors: E
authors: Kamer
authors: B
authors: B
authors: Zengel
authors: B
authors: B
authors: Uyar
authors: C
authors: C
authors: Tavusbay
authors: H R
authors: HR
authors: Unalp
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D003108:Colonic Diseases / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000401:mortality*; D017558:Elective Surgical Procedures / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality*; D012372:ROC Curve; D012002:Rectal Diseases / Q000601:surgery*; D012189:Retrospective Studies; D020379:Risk Adjustment / Q000379:methods*; D012307:Risk Factors