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 .
Validation of the CR-POSSUM Risk-Adjusted Scoring System for Major Colorectal Cancer Surgery in a Single Center
Purpose Scoring systems to predict mortality from surgery are important tools used to give information to the operator and patient and in the auditing of clinical practice . This study was design ed to vali date the recently developed the Colorectal Physiologic and Operative Severity Score for the Enumeration of Mortality and Morbidity ( CR-POSSUM ) scoring system in a single center for colorectal cancer surgery . We also analyzed whether albumin may have a role in the CR-POSSUM model . Methods We compared this model with two other scoring systems : POSSUM and Portsmouth-POSSUM ( P-POSSUM ) models .  In-hospital mortality was used as the outcome , and Hosmer-Lemeshow statistic was used to determine goodness of fit . Results Complete data were collected prospect ively from 304 patients from 1990 to the present . The overall operative mortality was 6.5 percent . Observed to expected ratios were used to compare the scoring systems at a given predicted mortality . The overall observed to expected ratio was 1.25 for CR-POSSUM , 1.59 for P-POSSUM , and 3.37 for POSSUM . The CR-POSSUM model showed a good fit with the data ( Hosmer-Lemeshow statistic , 3.86 ; P = 0.795 ) and the area under the receiver operator curve was 0.74 . After correcting for factors used in the CR-POSSUM , logistic regression showed a significant correlation between albumin and mortality ( P = 0.016 ) . Conclusions We have shown that the CR-POSSUM model is an accurate predictor of outcome for major colorectal surgery . The POSSUM and P-POSSUM models over-predicted mortality . Albumin , which is not a factor included in these three systems , may be an important addition in improving the accuracy of the CR-POSSUM model
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 .