Conclusions P-POSSUM was the most accurate model for predicting post-operative mortality after colorectal cancer surgery .
The original POSSUM model was accurate in predicting post-operative complications
Introduction The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity  ( POSSUM ) model and its Portsmouth ( P-POSSUM ) and colorectal ( CR-POSSUM ) modifications are used extensively to predict and audit post-operative mortality and morbidity .
This aim of this systematic review was to assess the predictive value of the POSSUM models in colorectal cancer surgery .
A newly devised scoring system for prediction of mortality in patients with colorectal cancer: a prospective study.
BACKGROUND Postoperative morbidity and mortality from colorectal cancer varies widely across hospitals in the UK . We aim ed to assess whether a newly developed score from the Association of Coloproctology of Great Britain and Irel and ( ACPGBI ) could predict mortality from colorectal cancer surgery as accurately as the Physiology and Operative Severity Score for enUmeration of Mortality and morbidity ( POSSUM ) , Portsmouth POSSUM ( P-POSSUM ) , or the ColoRectal POSSUM ( CR-POSSUM ) . METHODS We analysed prospect ively 618 patients with histologically confirmed colorectal cancer who had surgery to remove primary tumours done by colorectal surgeons or non-colorectal surgeons in a 3-year period . We compared observed mortality with those predicted by the ACPGBI , POSSUM , P-POSSUM , and CR-POSSUM scoring systems using the Hosmer-Lemeshow test and Receiver Operating Characteristic ( ROC ) curve analysis . FINDINGS Between April 1 , 2002 , and May 31 , 2005 , 618 consecutive patients with colorectal cancer had surgery to remove primary tumours . Overall observed 30-day mortality over the 3 years was 10.2 % ( 95 % CI 8.0 - 12.9 ) . Overall predicted mortality ( mean score ) by use of POSSUM was 12.7 % ( 11.7 - 13.7 ) , by use of P-POSSUM was 4.4 % ( 3.4 - 5.4 ) , by use of CR-POSSUM was 9.6 % ( 8.6 - 10.6 ) , and by use of ACPGBI score was 8.1 % ( 7.3 - 8.8 ) . INTERPRETATION POSSUM overpredicted mortality , whereas P-POSSUM underpredicted mortality from colorectal-cancer surgery . CR-POSSUM was a more-accurate predictor of mortality in most analyses than was POSSUM and P-POSSUM . Although CR-POSSUM gave the closest prediction of overall mortality , analyses of subgroups of patients showed that ACPGBI score predicted overall mortality most accurately
Conclusions P-POSSUM was the most accurate model for predicting post-operative mortality after colorectal cancer surgery .
The original POSSUM model was accurate in predicting post-operative complications
Introduction The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity  ( POSSUM ) model and its Portsmouth ( P-POSSUM ) and colorectal ( CR-POSSUM ) modifications are used extensively to predict and audit post-operative mortality and morbidity .
This aim of this systematic review was to assess the predictive value of the POSSUM models in colorectal cancer surgery .