POSSUM, P-POSSUM, CR-POSSUM ve ACPGBI-CRC skorlama sistemlerinin, kolorektal karsinomlu hastalarda mortalite tahminindeki duyarlılıklarının karşılaştırılması (Retrospektif çalşıma)
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Tarih
2017
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info:eu-repo/semantics/openAccess
Özet
Kolorektal kanser cerrahi operasyon sonrası gelişecek sonuçları tahmin etmek için skorlama sistemleri geliştirilmiştir. Bizim amacımız kolorektal kanser nedeniyle opere edilen hastaların, postoperatif mortalite değerlendirmede kullanılan POSSUM, P- POSSUM, CR- POSSUM ve ACPGBI-CRC skorlama sistemlerinin postoperatif mortaliteyi belirlemede hangisinin daha duyarlı olduğunu karşılaştırmaktır. Materyal ve metod: Çalışmamızda Ocak 2002 ile Haziran 2007 tarihleri arasında Dicle Üniversitesi Tıp Fakültesi Genel Cerrahi Kliniği'nde kolorektal kanser nedeniyle ameliyat edilen 130 hasta vardı. . POSSUM, P-POSSUM, CR-POSSUM ve ACPGBI-CRC skorlama sistemlerinin postoperatif mortalitenin doğruluğunu belirlemede Receiver Operator Characteristic (ROC) eğri analizi ve Hosmer-Lemeshow testi kullanıldı. Bulgular: Postoperatif 30 günlük gözlenen mortalite yüzdesi 13.07 (%95 CI 8.32-19.93) idi. Mortalite tahmin güçleri POSSUM için 6.15 (3.14-11.66) p=0.0925 ; P-POSSUM için 5.38 (2.62 10.69) p=0.0538; CR-POSSUM için 8.44 (4.78-14.51), p=0.3178; ACPGBI-CRC için 9.23 (5.35- 15.44), p=0.4315 idi. Ve doğruluklarını değerlendirmek için ROC eğri analizi yapıldığında AUC değerleri CR-POSSUM için 0.969 (0.922-0.991), p=0.270; P-POSSUM için 0.959 (0.909-0.986), p=0.232; POSSUM için 0.949 (0.896-0.980), p=0.167. olarak bulundu. Sonuç: Tüm skorlama sistemleri postoperatif mortaliteyi belirlemede anlamlıdır. Ancak tüm hastaları değerlendirmede mortaliteyi en az tahmin eden skorlama sistemi P-POSSUM olarak bulundu. Postoperatif mortaliteyi belirlemede CR-POSSUM ve ACPGBI-CRC skorlama sistemlerinin daha anlamlı olduğu görüldü. CR-POSSUM ve ACPGBI-CRC skorlama sistemleri karşılaştırıldığında istatistiksel olarak anlamlı bir fark saptanmadı. ROC eğri analizinde de skorlama sistemleri arasında anlamlı bir fark saptanmamıştır.
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 .
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 .
Açıklama
Anahtar Kelimeler
Genel cerrahi, General surgery, Kolorektal kanser
