POSSUM预测老年胸部术后并发症的价值及其与Clavien-Dindo分级的相关性  

The value of POSSUM score system in predicting postoperative complications in elderly patients and its correlation with Clavien-Dindo classification

作　　者：周乾华 张亮 施益明 王海洋 ZHOU Qianhua;ZHANG Liang;SHI Yiming;WANG Haiyang(Department of Thoracic and Cardiac Surgery,Anhui No.2 People’s Hospital,Hefei,Anhui 230000,China)

机构地区：[1]安徽省第二人民医院胸心外科,合肥230000

出　　处：《重庆医学》2024年第4期542-546,554,共6页Chongqing medicine

基　　金：安徽省卫生和计划生育委员会科研计划项目(2018SEYL024)。

摘　　要：目的探讨生理学及手术严重性评分(POSSUM)预测老年胸部术后并发症的价值,并分析其与Clavien-Dindo分级的相关性。方法回顾性分析2019年10月至2023年3月于该院行胸部手术的182例患者临床资料,根据术后是否发生并发症分为并发症组(n=75)和无并发症组(n=107),分析两组基线资料及POSSUM,绘制受试者工作特征(ROC)曲线分析POSSUM对老年胸部术后发生并发症的预测价值,比较不同Clavien-Dindo分级患者POSSUM,并分析POSSUM与Clavien-Dindo分级相关性。结果并发症组以肺部感染发生率最高,低蛋白血症次之。并发症组术前POSSUM高于无并发症组,差异有统计学意义(P<0.05)。ROC曲线显示POSSUM的AUC值为0.829;并发症组Clavien-Dindo分级中Ⅰ级5例,Ⅱ级47例,Ⅲ级8例,Ⅳ级7例,Ⅴ级8例,老年胸部手术患者术后不同Clavien-Dindo分级并发症患者POSSUM比较,差异有统计学意义(P<0.05)。相关性分析结果显示,POSSUM与Clavien-Dindo分级呈正相关(r=0.513,P<0.05)。结论POSSUM预测老年胸部术后并发症的价值较高。Objective To explore the value of the Physiology and Surgical Severity Score(POSSUM)scoring system in predicting postoperative complications in elderly patients with thoracic surgery,and to analyze its correlation with Clavien-Dindo classification.Methods The data of 182 elderly patients who underwent thoracic surgery in this hospital from October 2019 to March 2023 were retrospectively analyzed.They were divided into the complication group and the non-complication group according to whether there were complications after surgery.The baseline data and POSSUM score of the two groups were analyzed,and the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of POSSUM for postoperative complications in elderly patients.POSSUM of patients with different Clavien-Dindo classification was compared,and the correlation between POSSUM and Clavien-Dindo classification analyzed.Results The incidence of pulmonary infection was the highest in the complication group,followed by hypoproteinemia.POSSUM in the complication group was higher than that in non-complication group before operation,and the difference was statistically significant(P<0.05).The ROC curve showed that the area under curve(AUC)value of POSSUM was 0.829;In the complication group,according to Clavien-Dindo classification,there were 5 cases of gradeⅠ,47 cases of gradeⅡ,8 cases of gradeⅡⅢ,7 cases of gradeⅣand 8 cases of gradeⅤ,the difference was statistically significant(P<0.05).The correlation analysis showed that POSSUM score was positively correlated with Clavien-Dindo classification(r>0.513,P<0.05).Conclusion The POSSUM scoring system has a high value in predicting postoperative complications in elderly patients with thoracic surgery.

关 键 词：生理学及手术严重性评分 老年胸部手术 并发症 Clavien-Dindo分级 相关性 

分 类 号：R655[医药卫生—外科学]