Comparison of Physiological and Operative Severity Score for Enumeration of Mortality and Morbidity POSSUM and its Portsmouth Modification P-POSSUM as a tool for prediction of mortality and morbidity in patients undergoing emergency laparotomy
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2019, Vol 4, Issue 7
Abstract
Introduction In the recent era, patient’s surgical outcome has been used as an indicator of patient’s quality of care. A number of scoring systems have been developed to predict the risk of peri-operative morbidity and mortality. Aim of this study was to access and compare POSSUM (Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity) and its Portsmouth modification (P-POSSUM) equation for predicting morbidity and mortality in patients undergoing emergency laprotomy. Material And Methods This prospective, observational study was conducted in SMS Hospital, Jaipur from March 2015 to May 2016. Patients, who underwent emergency laprotomy, were included. All patients were scored depending on their physiological parameters at the time of admission. An operative severity score was calculated based on intraoperative findings and final expected mortality and morbidity rate was calculated. This was compared with observed mortality and morbidity. Patients were followed up for 30 days following the surgery. The risk of morbidity and mortality was calculated using POSSUM and P- POSSUM equations. Results In this study, 75 patients (50%) developed complications and 19 patients (12.6%) expired (observed death). POSSUM equation for mortality estimated 37 deaths with linear method of analysis and 20 deaths with exponential method of analysis. P-POSSUM equation for mortality estimated 19 deaths with linear method of analysis and 20 deaths with exponential method of analysis. Conclusion Exponential method of analysis for POSSUM and linear method of analysis for P-POSSUM scoring system are valid in predicting death of patients undergoing emergency laprotomy.
Authors and Affiliations
Dr. Shalu Gupta
Keywords
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