Risk Prediction And Factors Research Of Operative Complications In Elderly Patients With Soft Tissue Sarcoma

Objective:To confirm the clinical value of POSSUM scoring system in predicting surgical complications in elderly patients with soft tissue sarcoma; look for the surgery relative risk factor; reduce preoperative complication rate and mortality; improve the surgical success ratio, and provide the evidence for risk assessment system. Method:A retrospective analysis was conducted in Xinjiang Medical University attached tumor Hospital, including 140 cases of old age with soft tissue sarcoma from April 2005 to October 2010. POSSUM scoring system was applied to each case. The preoperative physiological score and operative severity score were taken into the prediction equation to predict postoperative complication rate. Drawing the ROC curve evaluated the clinical value of POSSUM scoring system predicting complication. Based on 18 factors in taking POSSUM scoring system, we excluded 7 nondiscriminatory factors, and added to 8 associated clinical factors, Univariate screening was carried on 19 factors including age, cardiac sings, chest radiograph, systolic BP, pulse, hemoglobin, white cell count, serum sodium and potassium, magnitude, blood loss, presence of malignancy, preoperative albumin, KPS score, tumor size and depth, surgical method, operative time, preoperative radiotherapy, preoperative coronary diabetes; and multi-factors carried on two classify Logistic regression analysis. Result:For POSSUM scoring system predicting postoperative complications, ROC curve area was 0.697 (P=0.000), so its forecast accuracy was relatively low. Single factor analysis showed that the difference had statistically significant in preoperative albumin (P=0.000), KPS score (P=0.000), tumor size (P=0.000), tumor depth (P=0.000), Presence of malignancy (P=0.013), Blood loss (P=0.000), preoperative radiation therapy (P=0.006).Two classify Logistic regression analysis showed that preoperative albumin, tumor size and depth, preoperative radiotherapy had statistics significances. Conclusion:POSSUM scoring system in predicting surgical complication rate in this group of patients had certain clinical value, but the accuracy was somewhat low. The Logistic regression analysis showed that preoperative hypoproteinemia, preoperative radiotherapy, Larger tumors, deep tumors were risk factors of postoperative complications. While POSSUM scoring system did not include four factors (albumin, preoperative radiotherapy, tumor size and depth), therefore in predicting surgical complications in elderly patients with soft tissue sarcoma needed further clinical verification or improvement.