Evaluation of the Usefulness of Score Systems for the Postoperative Risk Assessment inPatients with Colorectal Perforation

Abstract

The purpose of this study was to clarify the usefulness of predictive scoring systems for the postoperative mortality of patients with colorectal perforation using the Acute Physiological and Chronic Health EvaluationII (APACHEII), Sequential Organ Failure Assessment (SOFA), Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM), and the Mannheim Peritonitis Index (MPI). A total of 54 patients with colorectal perforation underwent a surgical procedure in our hospital between 2006 and 2011. The score of each risk assessment was retrospectively calculated, and the association between each score and mortality was evaluated in these patients. Furthermore, optimal cut-off values for the mortality were determined by Receiver Operating Characteristics (ROC) curve analysis for each system. The each risk assessment score was significantly higher in the non-survivors than in the survivors. According to the optimal cut-off values for the mortality, the APACHEII system had the highest sensitivity (100%), and the SOFA system had the highest specificity and accuracy (90% and 89%) among the four risk assessment systems. In conclusion, APACHEII and SOFA systems were useful for predicting postoperative mortality in patients with colorectal perforation.