Predictive value of POSSUM scoring system for postoperative complications and mortality in elderly patients with colorectal cancer

Abstract

BACKGROUND:

The POSSUM scoring system, widely employed in assessing surgical risks, offers a simplified and objective approach for the prediction of complications and mortality in patient. Despite its effectiveness in various surgical fields, including orthopedics and cardiovascular surgery, yet its utilization in elderly patients undergoing colorectal cancer surgery is infrequent.

OBJECTIVE:

To analyze the predictive value of POSSUM scoring system for postoperative complications and mortality in elderly with colorectal cancer.

METHODS:

306 elderly colorectal cancer patients were grouped according to the complications and death within 30 days after surgery. Among them, 108 cases in complication group, 198 cases in non-complication group, 16 cases in death group and 290 cases in survival group. POSSUM scores of all subjects were obtained and its predictive value for postoperative complications and mortality of elderly was conducted by ROC curve.

RESULTS:

No apparent difference were observed in complications and mortality among patients with different disease types, operation types and operation timing ( $P>$ 0.05). The R2 in complication group was higher than non-complication group ( $P<$ 0.05). The R1 in death group were higher than survival group ( $P<$ 0.05). The AUC of R2 for predicting postoperative complications was 0.955 with a sensitivity of 88.89% and a specificity of 94.44% and the AUC of R1 for evaluating postoperative mortality of elderly with colorectal cancer was 0.783 with a sensitivity of 56.25% and a specificity of 82.93%.

CONCLUSION:

POSSUM score system has a certain predictive value for postoperative complications and mortality in elderly with colorectal cancer. However, the predicted mortality rate is higher than actual mortality rate.