Evaluation of Possum Scoring in Patients Undergoing Emergency Laparotomy for Hollow Viscus Perforation
Journal Title: IOSR Journal of Pharmacy and Biological Sciences (IOSR-JPBS) - Year 2016, Vol 11, Issue 4
Abstract
Back Ground And Objectives: POSSUM and P-POSSUM equations have been validated and used extensively in general surgery and subspecialties, but its use in emergency setting has not been that extensively studied. Hence the aim of the present study was to evaluate the efficacy of POSSUM scoring as a risk assessment tool in predicting morbidity and mortality for patients undergoing Emergency laparotomy for hollow viscus perforation and to study the correlation between accepted and institutional standards. Results: This prospective, observational, descriptive study was conducted among 100 purposively selected patients who had underwent emergency midline laparotomy for hollow viscus perforation in the emergency department of Institute of General Surgery, Madras Medical College, Chennai .The study was carried out in a view to determine the validity of POSSUM scoring in predicting the morbidity and mortality in patients undergoing emergency midline laparotomy. The standards of our institution compared to the general accepted level of morbidity and mortality was also analysed. In our study there were a total of 100 patients studied . All the patients underwent midline laparotomy incision with appropriate procedures as per their pathology. 37 percent of the patients developed morbidity. The most common being wound dehiscence, followed by wound infection, UTI, Pneumonia, ARDS and anastomotic leak. Four patients among the study group died due to MODS.Among the four patients died, the POSSUM predicted mortality percentage was more than ninty percent in three of the patients. This indicates high level of sensitivity in predicting the mortality. But in the case of morbidity the expected and observed ratios differed. Chi square analysis of significance of POSSUM score to predict morbidity and mortality among the study group showed a high level of significance for mortality of <0.005 but in case of morbidity it is about 0.3. Conclusion: From our study, it has been evaluated that POSSUM scoring in patients with perforation peritonitis is a significant tool to evaluate the mortality and morbidity outcomes of the patients.
Authors and Affiliations
Dr. R . Manivannan1, Dr. M. Prabhakaran
Keywords
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- EP ID EP385873
- DOI 10.9790/3008-110404104113
- Views 67
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