Predictive Value Of Four Scoring System In Radical Gastrectomy

BackgroundWith increasing the incidence of gastric cancer each year,a high value of scoring system to predicting the postoperative morbidity and mortality are important to help physician to make surgical decision process after operation.PurposeThe aim of this study was to compare the value of POSSUM, p-POSSUM, o-POSSUM, APACHEⅡscoring systems to predict the postoperative mortality and morbidity in patients undergoing radical treatment for gastric cancer.Methods306 gastric cancer adults, who had been diagnosed by electronic gastroscope before radical gastrectomy or doing an intraoperative pathologic examination and underwent radical gastrectomy, were evaluated by using POSSUM, p-POSSUM, o-POSSUM, APACHEⅡscores. Receiver operating characteristic curve (ROCs),H osmer一Lemeshowχ2 test,Student's t-test andχ2-test analyses were used to estimate the predictive ability of these scoring systems.ResultsThe overall morbidity was 34.0%,a mean expected by POSSUM was 36.6%(O/E Ratio,0.93;p>0.05;AUCs=0.790,H osmer一Lemeshow test p >0.05).The overall mortality was 2.9%,the results shown that p-POSSUM(O/E Ratio,0.91;p>0.05;AUCs=0.760,H osmer一Lemeshow test p >0.05) and o-POSSUM(O/E Ratio,1.26;p>0.05;AUCs=0.882,Hosmer一Lemeshow test p >0.05) scores equally predicted postoperative mortality and were superior to the POSSUM (O/E Ratio,0.34;p<0.05,AUCs=0.628 , Hosmer一Lemeshow test p >0.05)and APACHEⅡscores(O/E Ratio,0.28;p<0.05;AUCs=0.632,H osmer一Lemeshow test p<0.05).ConclusionsThe POSSUM scoring system had a high value for predicting the risk of morbidity following radical surgery of gastric cancer. And both the p-POSSUM and o-POSSUM scores were more accurately in predicting postoperative mortality than the other two scores.