Perioperative Mortality Prediction Using Possum in Patients with Gastrointestinal Tumors: Do Immunological Variables Affect Individual Predictive Mortality Risk?

IF 0.5 4区 医学 Q4 BIOCHEMISTRY & MOLECULAR BIOLOGY Pteridines Pub Date : 2018-10-01 DOI:10.1515/pteridines-2018-0012
A. Engin, A. Engin, O. Kurukahvecioglu, A. Sepici‐Dinçel
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Abstract

Abstract The aim of this study was to evaluate whether the addition of immunological variables to the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) scoring system improves the predictability of postoperative mortality. One hundred and thirty-two consecutive patients who underwent moderate, major or major-plus elective surgical interventions for gastrointestinal tumors were scored using the POSSUM mortality risk analysis. Patients were placed in one of the two groups based on their POSSUM mortality rates which were either lower or higher than 5%. An additional 26 pre-operative and post-operative metabolic and immunological variables were measured and mortality-dependent variables were selected. Regression analysis with backward elimination of twelve pre-operative and post-operative variables correlating with POSSUM score revealed that post-operative neopterin, IL-6 and albumin were significantly dependent on the predicted mortality rates. According to these selected variables, the number of patients with a POSSUM predicted mortality rate higher than 5% increased from 64 to 88, but the percentage of the mean mortality decreased. Statistical differences between the original POSSUM and modified scoring system was highly significant (p<0.0001). The sensitivity and specificity of the modified scoring system was calculated to be 52.9% and 87.5%, respectively.
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用负鼠预测胃肠道肿瘤患者围手术期死亡率:免疫变量影响个体预测死亡率风险吗?
摘要本研究的目的是评估在死亡率和发病率增加的生理和手术严重程度评分(POSSUM)评分系统中添加免疫变量是否能提高术后死亡率的可预测性。使用POSSUM死亡率风险分析对132名连续接受中度、重度或重度加选择性胃肠道肿瘤手术干预的患者进行评分。根据POSSUM死亡率低于或高于5%,将患者分为两组中的一组。另外测量了26个术前和术后代谢和免疫变量,并选择了死亡率相关变量。对12个与POSSUM评分相关的术前和术后变量进行后向消除的回归分析显示,术后新蝶呤、IL-6和白蛋白显著依赖于预测的死亡率。根据这些选定的变量,POSSUM预测死亡率高于5%的患者人数从64人增加到88人,但平均死亡率的百分比有所下降。原始POSSUM和改良评分系统之间的统计学差异非常显著(p<0.0001)。改良评分系统的敏感性和特异性分别为52.9%和87.5%。
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来源期刊
Pteridines
Pteridines 生物-生化与分子生物学
CiteScore
1.20
自引率
25.00%
发文量
6
审稿时长
>12 weeks
期刊介绍: Pteridines is an open acess international quarterly journal dealing with all aspects of pteridine research. Pteridines are heterocyclic fused ring compounds involved in a wide range of biological functions from the color on butterfly wings to cofactors in enzyme catalysis to essential vitamins. Of the pteridines, 5,6,7,8-tetrahydrobiopterin is the necessary cofactor of several aromatic amino acid monoxygenases, the nitric oxide synthases and glyceryl ether monoxygenase (GEMO). Neopterin plays an essential role in the immune system and is an important biomarker in laboratory medicine for diseases such as HIV, cardiovascular disease, malignant tumors, among others. Topics: -Neopterin, dihydroneopterin, monapterin- Biopterin, tetrahydrobiopterin- Folates, antifolates, riboflavin- Phenylalanine, tyrosine, phenylketonuria, serotonin, adrenalin, noradrenalin, L-DOPA, dopamine, related biogenic amines- Phenylalanine hydroxylase, tyrosine hydroxylase, tryptophan hydroxylase, nitric oxide synthases (iNOS), alkylglycerol monooxygenase (AGMO), dihydropterin reductase, sepiapterin reductase- Homocysteine, mediators of inflammation, redox systems, iron.
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