The comparition of sensitivity of mortality prediction of POSSUM, P-POSSUM, CR-POSSUM and ACPGBI-CRC scoring systems in patients with colorectal carsinomas

Scoring systems was developed to predict outcomes after surgical operation for colorectal carcinomas. Our aim was to compared POSSUM, P- POSSUM, CR- POSSUM and ACPGBI-CRC scoring systems to detirmine which one is the most predictive factor for mortality in patients undergoing colorectal cancer surgery.Material and method: 130 patients with colorectal cancer surgery operated at Dicle university medical faculty general surgical clinic between january 2002 and july 2007 were included in this study. Receiver Operator Characteristic (ROC) curve analyz and Hosmer-Lemeshow test were used to determine accuracy of postoperative mortality for POSSUM, P- POSSUM, CR- POSSUM and ACPGBI-CRC scoring systems.Findings: Overall observed mortality rate for postoperative 30 days was 13.07 (95% CI 8.32-19.93). The predictive impatc of mortality for POSSUM 6.15 (3.14-11.66) p=0.0925 ; for P-POSSUM 5.38 (2.62 10.69) p=0.0538; for CR-POSSUM 8.44 (4.78-14.51), p=0.3178; and for ACPGBI-CRC 9.23 (5.35- 15.44), P=0.4315. to determine accuracy of scoring systems Receiver Operator Characteristic (ROC) curve analyz was used and the following AUC values were found: CR-POSSUM 0.969 (0.922-0.991), p=0.270; P-POSSUM 0.959 (0.909-0.986), p=0.232; POSSUM 0.949 (0.896-0.980), p=0.167.Results: POSSUM, P- POSSUM, CR- POSSUM and ACPGBI-CRC scoring systems were found significant to pedict postoperative mortality. However , P-POSSUM scoring was the least predictive in all patients. CR-POSSUM and ACPGBI-CRC scorings were more significant to predict postoperative mortality. Statisticaly there was no significant difference between CR-POSSUM and ACPGBI-CRC when compared. There was no significant difference between POSSUM, P- POSSUM, CR- POSSUM and ACPGBI-CRC scoring systems in ROC curve analysiz .