A STUDY TO ASSESS THE VALIDITY OF PORTSMOUTH POSSUM SCORING SYSTEM IN IDENTIFYING RISK FACTORS FOR LOW OUTCOME IN GENERAL SURGICAL PRACTICE
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2019, Vol 6, Issue 12
Abstract
BACKGROUND The Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity (POSSUM) and its modification the Portsmouth POSSUM, have been proposed as a method for standardising patient data so that direct comparisons can be made in spite of differing patterns of referral and population. Application of the POSSUM scoring system in this country where the level of healthcare and resources differ, is limited. In this prospective study, the validity of P-POSSUM was tested in patients undergoing major surgery and the risk factors for low outcome were noted. MATERIALS AND METHODS Some 150 major surgeries, as defined by the POSSUM scoring system criteria were studied. Predicted mortality rates were calculated using the P-POSSUM equation by linear analysis method. It was then compared with the actual outcomes. The risk factors as scored in the POSSUM criteria were noted. RESULTS Applying linear analysis, an observed to expected ratio of 0.98 was obtained, indicating a significant fit for predicting the postoperative adverse outcome. There was no significant difference between the observed and predicted mortality rates (x 2= 0.252, 9 d.f., p = 0.873). It was found to be comparable to other studies. In all the risk factors studied, a positive correlation was found between deaths and higher POSSUM scores. CONCLUSION Portsmouth POSSUM scoring system serves as a good predictor of post-operative outcome in major general surgical procedures and was applicable even in our setup and can be used for comparing various treatment modalities and assessing the quality of care provided.
Authors and Affiliations
Charan Panda, Asutosh Hotta, Manas Ranjan Behera, Subhabrata Das, Trishul Senapati A.
Keywords
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- EP ID EP615666
- DOI 10.18410/jebmh/2019/206
- Views 75
- Downloads 0
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