Predictive value of physiological capacity and surgical stress scores for perioperative complications in radical resection for colorectal cancer: a propensity-matched analysis.

Abstract

Purpose: To investigate the predictive value of physiological capacity and surgical stress scores for perioperative complications in radical resection for colorectal cancer (CRC).

Methods: A retrospective case-control study was performed from October 2021 to October 2023 at a single center, involving patients scheduled for radical resection of CRC. Patients were divided into groups with and without perioperative complications, and a propensity score matching was performed to minimize potential bias from clinical confounding variables. General patient data, including demographic information, comorbidities, tumor characteristics, surgical parameters, postoperative recovery, and Estimation of Physiologic Ability and Surgical Stress (E-PASS) scores, were collected and analyzed.

Results: After propensity score matching, factors such as age, diabetes, pulmonary disease, heart disease, and American Society of Anesthesiologists (ASA) grade remained significant predictors for complications (P < 0.05). Prolonged operation, increased blood loss, specific surgery types, and emergent surgeries were linked to a higher risk of perioperative complications (all P < 0.05). Patients with complications experienced longer postoperative hospital stays, increased adjuvant chemotherapy use, and lower quality of life scores (all P < 0.05). Perioperative risk score (PRS), surgical stress score (SSS), and composite risk score (CRS) were positively correlated with the incidence of perioperative complications (all P < 0.001). The AUC values for PRS, SSS, and CRS were 0.848, 0.854, and 0.882 respectively, indicating moderate to high predictive value for perioperative complications.

Conclusion: Physiological capacity and surgical stress scores, age, comorbidities, surgical parameters, postoperative recovery, and the E-PASS scores emerged as key predictive factors for perioperative complications in radical resection for CRC.