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©2007 Baishideng Publishing Group Co.
World J Gastroenterol. Oct 14, 2007; 13(38): 5090-5095
Published online Oct 14, 2007. doi: 10.3748/wjg.v13.i38.5090
Published online Oct 14, 2007. doi: 10.3748/wjg.v13.i38.5090
Clinic data | Postoperativecomplications | Postoperativedeath | Postoperativecomplications |
No. | 84 | 16 | 172 |
Age (yr) | 50-79 | 50-79 | 50-79 |
Average age | 68.67 ± 12.47 | 59.64 ± 13.48 | 69.82 ± 7.98 |
Gender (Male/Female) | 55/29 | 11/5 | 109/63 |
Diagnosis, n (%) | |||
Malignancy | 76 (90.5) | 12 (75.0) | 162 (94.2) |
Benign | 8 (9.5) | 4 (25.0) | 10 (5.8) |
Concomitant diseases, n (%) | |||
Yes | 14 (16.7) | 1 (6.3) | 68 (39.5) |
No | 70 (83.3) | 15 (93.7) | 104 (60.5) |
Factors | Suffered complications | Died | ||
RR | P | RR | P | |
Age (yr) > 60 | 0.681 | 0.356 | 0.211 | 0.008 |
> 70 | 2.181 | 0.005 | 0.391 | 0.091 |
> 80 | 1.469 | 0.356 | 0.549 | 0.569 |
Abnormal circulation system | 2.074 | 0.014 | 1.092 | 0.869 |
ECG mild change | 0.893 | 0.274 | 0.374 | 0.933 |
ECG ST-T change | 3.817 | 0.031 | 1.928 | 0.418 |
Abnormal respiratory system | 3.581 | 0.000 | 1.723 | 0.311 |
Liver function | 3.438 | 0.000 | 16.007 | 0.000 |
Blood system | 2.610 | 0.000 | 2.735 | 0.070 |
Renal function | 4.333 | 0.042 | 15.667 | 0.000 |
Gastrointestinal diseases | 15.545 | 0.011 | 5.571 | 0.046 |
Endocrine system | 2.374 | 0.002 | 1.615 | 0.359 |
Nutrition | 4.938 | 0.000 | 6.000 | 0.003 |
Central nervous system | 1.492 | 0.506 | 3.286 | 0.148 |
Operation time > 2 h | 1.097 | 0.096 | 0.028 | 0.112 |
Operation time > 4 h | 3.541 | 0.013 | 2.549 | 0.093 |
Operative hemorrhage > 300 mL | 0.783 | 0.306 | 0.481 | 0.216 |
Operative hemorrhage > 500 mL | 2.347 | 0.007 | 3.392 | 0.027 |
Palliative excision of malignant tumor | 0.693 | 0.047 | 2.014 | 0.082 |
Malignant tumor can’t excise | 7.139 | 0.000 | 5.175 | 0.000 |
BP < 90/60 mmHg during operation | 5.429 | 0.000 | 13.105 | 0.000 |
Steadyperioperative ECG monitoring | 7.781 | 0.000 | 16.001 | 0.000 |
Index | 0 | 1 | 2 | 3 | 4 |
Age (yr) | < 60 | 60-69 | 70-79 | ≥ 80 | |
Circulatory system | Normal Car Fun, BP, ECG | Car fun grade I, mild HP and abnormal ECG, sinoatrial bradycardia/tachycardia, low valtage of limb lead, BBB | Car fun grade II, Mod. HP, well controlled by med, occasional atrial premature beats | Car fun grade III, myocardial infarct < 3 mon, mod HP by med, ectopic, arythm, ST-T change, artrial fibrillation | Serious car, insuf, AHF, mal HP |
Respiratory system | Normal | Long history of smoking, CB, asthma, URI, thick pulmonary markings | Mild COPD, mild PF change, mild pneumo | Mod COPD, Mod to serious abnormal PF | Respiratory failure |
Liver function | Normal | History of hepatitis/cirrhosis of liver, TB < 34.2 μmol/L | TB 34.2-51.3 μmol/L | TB > 51.3 μmol/L | |
Renal function | Normal | BUN ≤ 10.1 mmol/L, Cr ≤ 170 μmol/L | BUN 10.1-15 mmol/L, Cr 170-300 μmol/L | Renal failure need dialysis | |
Gastrointestinal tract | Normal | History of chronic gastroenteritis, controlled peptic ulcer | Active gastrointestinal diseases(hemorrhage/ perforation of ulcers, active Crohn’s disease | Percutaneous intestinal fistula | Short bowel syndrome, transplantation of small bowels |
Blood system | Normal | PLT/WBC decreased mildly, Hb (rectified) > 85 g/L | Hematopathy as stable leukemia, WBC ≥ 14.5 × 109/L | Aplastic anemia, hypersplenism syndrome, leukemia etc. | |
Endocrine system | Normal | Mild increased BG, UGLu (-), treated hyperthyroidism, hypothyroidism, acromegaly, gout, rheumatoid disease | Mild increased BG, UGLu (+ - + +), and controlled DM, by oral medicine, hormonotherapy, active gout | DM, astable with oral medicine | Diabetic nephropathy |
Nutritional Status2 | Normal | Slight malnutrition (albumin 30-35 g/L, weight decrease < 2.5 Kg/m) | Moderate malnutrition (albumin < 30 g/L, mass decrease 2.5-5 kg/m); Radiotherapy/chemotherapy | Cachexia | |
GCS | 15 | 12-14 | 9-11 | ≤ 8 | |
Operative wound | Mino (OPT < 2 h/ hemorrhage volume < 300 mL) | Mod (OPT 2-4 h/hemorrhage volume 300-500 mL) | Major (OPT > 4 h/hemorrhage volume > 500 mL)/Palliative excision of Mal tumor | M Major++ (excision > 3 organs) /Mal tumor can’t excise | |
Anesthesia course | Arrhythmia/low BP < 1/2 h | continual low BP/ cardio-pulmonary resuscitation |
Group | n | M-POSSUM | t-test | |
t | P | |||
No complication | 172 | 6.51 ± 2.22 | -13.723 | 0.000 |
Complication | 84 | 11.04 ± 2.95 | ||
Alive | 240 | 7.58 ± 2.83 | -9.096 | 0.000 |
Dead | 16 | 14.25 ± 3.02 | ||
Alive with complication | 68 | 10.28 ± 2.38 | -5.693 | 0.000 |
Variaty | Area | SD | P |
M-POSSUM (predicting for morbidity) | 0.901 | 0.020 | 0.000 |
M-POSSUM (predicting for mortality) | 0.955 | 0.016 | 0.000 |
- Citation: Ding LA, Sun LQ, Chen SX, Qu LL, Xie DF. Modified physiological and operative score for the enumeration of mortality and morbidity risk assessment model in general surgery. World J Gastroenterol 2007; 13(38): 5090-5095
- URL: https://www.wjgnet.com/1007-9327/full/v13/i38/5090.htm
- DOI: https://dx.doi.org/10.3748/wjg.v13.i38.5090