APACHE II, POSSUM, and ASA scores and the risk of perioperative complications in patients with colorectal disease

Abstract

OBJECTIVE: This study was designed to assess the role of the ASA, POSSUM and APACHE II score systems for predicting the complications in patients undergoing surgery for colorectal diseases.

METHODS: We retrospectively analyzed 539 patients undergoing colorectal surgery between January 1996 and December 2006. The accuracy of ASA, POSSUM and APACHE II score systems for predicting perioperative complications has been analysed.

RESULTS: Total postoperative morbidity was 15%, overall perioperative mortality was 1.5%. APACHE II and POSSUM predicted with the same accuracy the perioperative complications (0.65 and 0.68, respectively), while ASA score system revealed a poorer predicting accuracy (0.56). POSSUM predicted death rate more accurately compared to the APACHE II classification (1.6% vs. 10.4%).

CONCLUSIONS: APACHE II and POSSUM score systems may be useful tools helping surgeons to identify patient groups at high risk for complications. The ASA classification resulted less accurate, probably because related to the anesthesiologist’s knowledge.