Examination of prognostic factors in patients undergoing surgery for colorectal perforation: A case controlled study

Tetsuo Sumi, Kenji Katsumata, So Katayanagi, Yuuki Nakamura, Tomohisa Nomura, Kiminori Takano, Kazuhiko Kasuya, Motohide Shimazu, Akihiko Tsuchida

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: To determine if the POSSUM, SOFA, MPI, and SAS scores provide a better measure of severity for patients with prognostic factors undergoing surgery for colorectal perforation. Subjects: Fifty-nine patients who underwent surgery between 1996 and 2012. Methods: We retrospectively reviewed background factors, blood and physiological test results, and intraoperative findings of patients who survived and those who died. We also compared the POSSUM, SOFA, MPI, and SAS scores. Multivariate analysis was performed for factors that were significant by univariate analysis, and selected factors were used to produce a predictive prognostic model. Results: Univariate analysis revealed significant differences in age, anticoagulant/steroid administration, serum creatinine level, PF ratio, base excess (BE), chest radiography, pulse rate, and severity of peritoneal soiling. Age, serum creatinine level, pulse rate, and severity of peritoneal soiling were selected for multivariate analysis; only pulse rate was significantly different. There were significant differences between the two groups in POSSUM PS, OSS, SOFA, and MPI scores, and a comparison in terms of the ROC curve showed that our model had the highest peak; the area under the curve was 94.8% compared with 70-80% for the other systems, suggesting that our model is better than those systems. Conclusions: POSSUM and SOFA are valid methods of evaluating risk from colorectal perforation, but our study revealed addition risk factors: (1) the PF ratio and BE, which are not included in POSSUM; (2) the pulse rate and severity of peritonitis, which are not included in SOFA; and (3) anticoagulant/steroid hormone administration.

Original languageEnglish
Pages (from-to)566-571
Number of pages6
JournalInternational Journal of Surgery
Volume12
Issue number6
DOIs
Publication statusPublished - 2014 Jan 1
Externally publishedYes

Fingerprint

Colorectal Surgery
Heart Rate
Base Composition
Anticoagulants
Creatinine
Multivariate Analysis
Steroids
Hematologic Tests
Peritonitis
Serum
Radiography
ROC Curve
Statistical Factor Analysis
Area Under Curve
Thorax
Hormones

Keywords

  • Colorectal perforation
  • Prognostic factor
  • Prognostic scoring system

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

Examination of prognostic factors in patients undergoing surgery for colorectal perforation : A case controlled study. / Sumi, Tetsuo; Katsumata, Kenji; Katayanagi, So; Nakamura, Yuuki; Nomura, Tomohisa; Takano, Kiminori; Kasuya, Kazuhiko; Shimazu, Motohide; Tsuchida, Akihiko.

In: International Journal of Surgery, Vol. 12, No. 6, 01.01.2014, p. 566-571.

Research output: Contribution to journalArticle

Sumi, T, Katsumata, K, Katayanagi, S, Nakamura, Y, Nomura, T, Takano, K, Kasuya, K, Shimazu, M & Tsuchida, A 2014, 'Examination of prognostic factors in patients undergoing surgery for colorectal perforation: A case controlled study', International Journal of Surgery, vol. 12, no. 6, pp. 566-571. https://doi.org/10.1016/j.ijsu.2014.03.021
Sumi, Tetsuo ; Katsumata, Kenji ; Katayanagi, So ; Nakamura, Yuuki ; Nomura, Tomohisa ; Takano, Kiminori ; Kasuya, Kazuhiko ; Shimazu, Motohide ; Tsuchida, Akihiko. / Examination of prognostic factors in patients undergoing surgery for colorectal perforation : A case controlled study. In: International Journal of Surgery. 2014 ; Vol. 12, No. 6. pp. 566-571.
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AU - Nomura, Tomohisa

AU - Takano, Kiminori

AU - Kasuya, Kazuhiko

AU - Shimazu, Motohide

AU - Tsuchida, Akihiko

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N2 - Objective: To determine if the POSSUM, SOFA, MPI, and SAS scores provide a better measure of severity for patients with prognostic factors undergoing surgery for colorectal perforation. Subjects: Fifty-nine patients who underwent surgery between 1996 and 2012. Methods: We retrospectively reviewed background factors, blood and physiological test results, and intraoperative findings of patients who survived and those who died. We also compared the POSSUM, SOFA, MPI, and SAS scores. Multivariate analysis was performed for factors that were significant by univariate analysis, and selected factors were used to produce a predictive prognostic model. Results: Univariate analysis revealed significant differences in age, anticoagulant/steroid administration, serum creatinine level, PF ratio, base excess (BE), chest radiography, pulse rate, and severity of peritoneal soiling. Age, serum creatinine level, pulse rate, and severity of peritoneal soiling were selected for multivariate analysis; only pulse rate was significantly different. There were significant differences between the two groups in POSSUM PS, OSS, SOFA, and MPI scores, and a comparison in terms of the ROC curve showed that our model had the highest peak; the area under the curve was 94.8% compared with 70-80% for the other systems, suggesting that our model is better than those systems. Conclusions: POSSUM and SOFA are valid methods of evaluating risk from colorectal perforation, but our study revealed addition risk factors: (1) the PF ratio and BE, which are not included in POSSUM; (2) the pulse rate and severity of peritonitis, which are not included in SOFA; and (3) anticoagulant/steroid hormone administration.

AB - Objective: To determine if the POSSUM, SOFA, MPI, and SAS scores provide a better measure of severity for patients with prognostic factors undergoing surgery for colorectal perforation. Subjects: Fifty-nine patients who underwent surgery between 1996 and 2012. Methods: We retrospectively reviewed background factors, blood and physiological test results, and intraoperative findings of patients who survived and those who died. We also compared the POSSUM, SOFA, MPI, and SAS scores. Multivariate analysis was performed for factors that were significant by univariate analysis, and selected factors were used to produce a predictive prognostic model. Results: Univariate analysis revealed significant differences in age, anticoagulant/steroid administration, serum creatinine level, PF ratio, base excess (BE), chest radiography, pulse rate, and severity of peritoneal soiling. Age, serum creatinine level, pulse rate, and severity of peritoneal soiling were selected for multivariate analysis; only pulse rate was significantly different. There were significant differences between the two groups in POSSUM PS, OSS, SOFA, and MPI scores, and a comparison in terms of the ROC curve showed that our model had the highest peak; the area under the curve was 94.8% compared with 70-80% for the other systems, suggesting that our model is better than those systems. Conclusions: POSSUM and SOFA are valid methods of evaluating risk from colorectal perforation, but our study revealed addition risk factors: (1) the PF ratio and BE, which are not included in POSSUM; (2) the pulse rate and severity of peritonitis, which are not included in SOFA; and (3) anticoagulant/steroid hormone administration.

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