Estimation of Operation Risk in Lung Cancer Patients Undergoing Surgery Using POSSUM_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

MA Zhu , LI Desheng , ABUDOUAINI Tuerhong , et al .

Department of Thoracic Surgery ，the First Affiliated Hospital of Xinjiang Medical University ，Urumqi 830054，P.R.China;

Corresponding author：

Keywords：

Lung cancer; POSSUM scoring system; Operation risk

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Abstract ： Objective To evaluate the clinical validity of Physiological and Operative Severity Score for the
enUmeration of Mortality and Morbidity (POSSUM) in primary lung cancer patients undergoing surgery in order to get clinical treatment reference. Methods A total of 179 patients，with 124 males and 55 females，with primary lung cancer surgery between January 2007 and October 2010 were included in the First Affiliated Hospital of Xinjiang Medical University. Their age was 59.2±11.4 years．Before the surgery，POSSUM was used to each patient to rate the results and substituted the results into Copeland equation to calculate the predicted postoperative mortality and morbidity. The actual number of complications and death were calculated after surgery and the patients were divided into one group with postoperative complications and another group without postoperative complications. The physiological score and the operative risk score were compared between the two groups. Actual number of complications and death were compared with the
number predicted by POSSUM respectively. The clinical factors related to the actual number of complications and death were analyzed. Results Among 179 patients， there were postoperative complications in 78 patients. The physiological score and the operative severity score were significantly higher in the group in whose complications occurred compared with those without complications (16.11±2.53 points versus 14.88±1.86 points for physiological score，P=0.000 ； 13.47±2.83 points versus 12.88±2.57 points for operative severity score，P=0.000). There was no statistical difference in complication between the predicted and actual number (65/179 versus 78/179，χ2=1.968，P=0.161). There was statistical difference in death between the predicted and actual number(12/179 versus 3/179，χ2=5.636，P=0.018).
Univariable analysis revealed that 5 single factors were related to the complications， only hemoglobin was related to the death. Conclusion The POSSUM gives satisfactory prediction in morbidity rate but overrates the mortality rate in primary lung cancer patients undergoing surgery， and 5 single clinical factors show a better clinical value.

Citation： MA Zhu,LI Desheng,ABUDOUAINI Tuerhong,et al .. Estimation of Operation Risk in Lung Cancer Patients Undergoing Surgery Using POSSUM. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(1): 31-35. doi: Copy

1.	systems for audit of major hepatectomy．Br J Surg，2004，91(4):.
2.	possum for patients undergoing pancreatoduodenectomy．World J Surg，2009，33(7)：1481-1487．.
3.	for patients with fractured neck of femur．Br J Anaesth，2005，.
4.	(POSSUM). Eur J Cardiothorac Surg，2001，19(6)：924-928．.
5.	P-POSSUM，and Cr-POSSUM：implementation issues in a united states health care system for prediction of outcome for colon cancer resection．Dis Colon Rectum，2004，47(9)：1435-1441．.
6.	Copeland GP，Jones D Walters M．POSSUM：A scoring system for surgical audit．Br J Surg，1991，78(3)：355-360．.
7.	Lam CM，Fan ST，Yuen AW，et al．Validation of POSSUM scoring.
8.	Bollschweiler E，Lubke T，Monig S．Evaluation of POSSUM scoring system in patients with gastric cancer undergoing D2-gastrectomy.BMC Surg，2005，5：8．.
9.	de Castro SM，Houwert JT，Lagarde SM，et al．Evaluation of.
10.	Ramanathan TS，Moppett IK，Wenn R，et al．POSSUM scoring.
11.	Hobson SA，Sutton CD，Garcea G，et al．Prospective comparison of POSSUM and P-POSSUM with clinical assessment of mortality following emergency surgery．Acta Anaesthesiol Scand，2007，51(1)：94-100．.
12.	de Cássia Braga Ribeiro K，Kowalski LP．APACHE II，POSSUM，and ASA scores and the risk of perioperative complications in patients with oral or oropharyngeal cancer．Arch Otolaryngol Head Neck Surg，2003，129(7)：739-745．.
13.	Das N，Talaat AS，Naik R，et al．Risk adjusted surgical audit in gynaecological oncology：P-POSSUM does not predict outcome．Eur J Surg Oncol，2006，32(10)：1135-1138．.
14.	Ceulemans R，Al-ahdab N，Leroy J，et al．Safe laparoscopic surgery in the elderly．Am J Surg，2004，187(3)：323-327．.
15.	Brunelli A，Fianchini A，Xiume F，et al．Evaluation of the POSSUM scoring system in lung resection surgery．Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity．Thorac Cardiovasc Surg，1998，46(3)：141-146.
16.	Brunelli A，Fianchini A，Gesuita R，et al．POSSUM scoring system as an instrument of audit in lung resection surgery．Ann Thorac Surg，1999，67(2)：329-331．.
17.	Brunelli A，Fianchini A，Al Refai RM，et al．Internal comparative audit in a thoracic surgery unit using the physiological and operative severity score for the enumeration of mortality and morbidity.
18.	杨利伟，乔志斌，何宏涛，等．Possum评分在判断食管贲门癌手术预后中的价值．中华外科杂志，2008，46(14)：1100-1102．.
19.	张军，张文君，郭家龙，等．POSSUM评分预测高龄食管癌及贲门癌患者术后并发症发生率的价值．中国误诊学杂志，2007，7(26)：6215-6217．.
20.	Ferjani AM， Griffin D，Stallard N，et al．A newly devised scoring system for prediction of mortality in patients with colorectal cancer：a prospective study．Lancet Oncol，2007，8(4)： 317-322．.
21.	Senagore AJ，Warmuth AJ，Delaney CP，et al．POSSUM，.
22.	Neary WD，Heather BP，Earnshaw JJ．The physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM)．Br J Surg，2003，90(2)：157-165．.
23.	Audisio RA，Bozzetti F，Gennari R，et al．The surgical management of elderly cancer patients;recommendations of the SIOG surgical task force．Eur J Cancer，2004，40(7)：926-938．.
24.	Slim K，Panis Y，Alves A，et al．Predicting postoperative mortality in patients undergoing colorectal surgery．World J Surg，2006，30(1)：100-106．.
25.	杨俊玲，张焕英，赵凤莲．肺功能测定对胸部手术风险的评估作用. 中华实用诊断与治疗杂志，2009，23(10)：1007-1008．.
26.	毛友生，张德超，张汝刚，等．低肺功能肺癌病人术后呼吸衰竭原因分析．中华胸心血管外科杂志，2003，19(3)：151-153．.
27.	雷艺炎，陈振光，罗红鹤，等．肺癌患者围术期并发症发生的危险因素分析．中国胸心血管外科临床杂志，2008，15(4)：268-271．.
28.	Roselli EE，Murthy SC，Rice TW，et al．Atrial fibrillation complicating lung cancer resection．J Thorac Cardiovasc Surg，2005，130(2)：438．.
29.	Sabiston DC， Spencer FC, 主编．第6版．北京：人民卫生出版社，2000．19-20．.
30.	(4)：430-433．.
31.	-454．.

1. systems for audit of major hepatectomy．Br J Surg，2004，91(4):.
2. possum for patients undergoing pancreatoduodenectomy．World J Surg，2009，33(7)：1481-1487．.
3. for patients with fractured neck of femur．Br J Anaesth，2005，.
4. (POSSUM). Eur J Cardiothorac Surg，2001，19(6)：924-928．.
5. P-POSSUM，and Cr-POSSUM：implementation issues in a united states health care system for prediction of outcome for colon cancer resection．Dis Colon Rectum，2004，47(9)：1435-1441．.
6. Copeland GP，Jones D Walters M．POSSUM：A scoring system for surgical audit．Br J Surg，1991，78(3)：355-360．.
7. Lam CM，Fan ST，Yuen AW，et al．Validation of POSSUM scoring.
8. Bollschweiler E，Lubke T，Monig S．Evaluation of POSSUM scoring system in patients with gastric cancer undergoing D2-gastrectomy.BMC Surg，2005，5：8．.
9. de Castro SM，Houwert JT，Lagarde SM，et al．Evaluation of.
10. Ramanathan TS，Moppett IK，Wenn R，et al．POSSUM scoring.
11. Hobson SA，Sutton CD，Garcea G，et al．Prospective comparison of POSSUM and P-POSSUM with clinical assessment of mortality following emergency surgery．Acta Anaesthesiol Scand，2007，51(1)：94-100．.
12. de Cássia Braga Ribeiro K，Kowalski LP．APACHE II，POSSUM，and ASA scores and the risk of perioperative complications in patients with oral or oropharyngeal cancer．Arch Otolaryngol Head Neck Surg，2003，129(7)：739-745．.
13. Das N，Talaat AS，Naik R，et al．Risk adjusted surgical audit in gynaecological oncology：P-POSSUM does not predict outcome．Eur J Surg Oncol，2006，32(10)：1135-1138．.
14. Ceulemans R，Al-ahdab N，Leroy J，et al．Safe laparoscopic surgery in the elderly．Am J Surg，2004，187(3)：323-327．.
15. Brunelli A，Fianchini A，Xiume F，et al．Evaluation of the POSSUM scoring system in lung resection surgery．Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity．Thorac Cardiovasc Surg，1998，46(3)：141-146.
16. Brunelli A，Fianchini A，Gesuita R，et al．POSSUM scoring system as an instrument of audit in lung resection surgery．Ann Thorac Surg，1999，67(2)：329-331．.
17. Brunelli A，Fianchini A，Al Refai RM，et al．Internal comparative audit in a thoracic surgery unit using the physiological and operative severity score for the enumeration of mortality and morbidity.
18. 杨利伟，乔志斌，何宏涛，等．Possum评分在判断食管贲门癌手术预后中的价值．中华外科杂志，2008，46(14)：1100-1102．.
19. 张军，张文君，郭家龙，等．POSSUM评分预测高龄食管癌及贲门癌患者术后并发症发生率的价值．中国误诊学杂志，2007，7(26)：6215-6217．.
20. Ferjani AM， Griffin D，Stallard N，et al．A newly devised scoring system for prediction of mortality in patients with colorectal cancer：a prospective study．Lancet Oncol，2007，8(4)： 317-322．.
21. Senagore AJ，Warmuth AJ，Delaney CP，et al．POSSUM，.
22. Neary WD，Heather BP，Earnshaw JJ．The physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM)．Br J Surg，2003，90(2)：157-165．.
23. Audisio RA，Bozzetti F，Gennari R，et al．The surgical management of elderly cancer patients;recommendations of the SIOG surgical task force．Eur J Cancer，2004，40(7)：926-938．.
24. Slim K，Panis Y，Alves A，et al．Predicting postoperative mortality in patients undergoing colorectal surgery．World J Surg，2006，30(1)：100-106．.
25. 杨俊玲，张焕英，赵凤莲．肺功能测定对胸部手术风险的评估作用. 中华实用诊断与治疗杂志，2009，23(10)：1007-1008．.
26. 毛友生，张德超，张汝刚，等．低肺功能肺癌病人术后呼吸衰竭原因分析．中华胸心血管外科杂志，2003，19(3)：151-153．.
27. 雷艺炎，陈振光，罗红鹤，等．肺癌患者围术期并发症发生的危险因素分析．中国胸心血管外科临床杂志，2008，15(4)：268-271．.
28. Roselli EE，Murthy SC，Rice TW，et al．Atrial fibrillation complicating lung cancer resection．J Thorac Cardiovasc Surg，2005，130(2)：438．.
29. Sabiston DC， Spencer FC, 主编．第6版．北京：人民卫生出版社，2000．19-20．.
30. (4)：430-433．.
31. -454．.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Estimation of Operation Risk in Lung Cancer Patients Undergoing Surgery Using POSSUM

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