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  • Poster presentation
  • Open Access

Perioperative scores to predict mortality in surgical oncologic patients: a review of 1,362 cases

  • 1,
  • 2,
  • 1,
  • 1 and
  • 1
Critical Care201014 (Suppl 1) :P250

https://doi.org/10.1186/cc8482

  • Published:

Keywords

  • Systemic Disease
  • Mortality Risk
  • Hospital Mortality
  • Oncologic Patient
  • Specific Score

Introduction

Surgical outcomes depend on many factors, including baseline characteristics and differences in surgical and anesthetic practices. Few data are available in general surgical oncological patients. We aimed to evaluate the predictive value of Porthsmouth POSSUM and American Society of Anesthesiologists (ASA) scores in oncologic patients submitted to surgical procedures.

Methods

Data were collected from a database filled with demographic characteristics, neoplasm definitions, co-morbidities and data from intraoperative room and hospital mortality. The predicted mortality risk was calculated using Porthsmouth POSSUM and ASA physical status grading.

Results

From 1,362 surgical patients, the observed general hospital mortality was 2.34%. ASA grading underestimated the mortality for low-complexity patients, overestimated in patients with severe systemic disease (ASA III), and was a strong predictor of mortality in patients with life-threatening conditions (ASA IV) (Table 1). On the other hand, the Porthsmouth POSSUM scoring system overestimated mortality in all groups (Table 2).
Table 1

Observed and predicted mortality of oncologic patients evaluated through ASA physical status grading

ASA

Number

Observed

Predicted

ASA I

209

4 (1.91%)

1 (0.05%)

ASA II

867

10 (1.15%)

1 (0.4%)

ASA III

247

7 (2.83%)

11 (4.5%)

ASA IV

39

11 (28.2%)

10 (25%)

Total

1,362

32 (2.34%)

 
Table 2

Observed and predicted mortality of oncologic patients evaluated through Portsmouth POSSUM scoring

Number

Observed

Predicted

0 to 5

0

0

0 (3.1%)

5 to 30

1,055

15 (1.42%)

142 (13.5%)

30 to 100

307

17 (5.53%)

149 (48.7%)

0 to 100

1,322

32 (2.34%)

  

Conclusions

In surgical oncologic patients, Porthsmouth POSSUM and ASA are not good predictors of mortality. These data suggest that a more sensible and specific score is needed in this population.

Authors’ Affiliations

(1)
Instituto do Cancer do Estado de São Paulo, Brazil
(2)
Heart Institute, São Paulo, Brazil

References

  1. Wakabayashi H, et al.: Int J Surg. 2007, 5: 323-327. 10.1016/j.ijsu.2007.03.003PubMedView ArticleGoogle Scholar

Copyright

© BioMed Central Ltd. 2010

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