Portsmouth Possum Scoring in General Surgery, identifying Risk Factors for low outcome And Predicting Post operative Mortality.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 2
Abstract
Background and objectives: 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 to predict their mortality rate and to compare its accuracy as well as to identify a cut off range in the score to predict a higher percentage of mortality in the cases Methods: 200 surgeries in minor, moderate and major+ categories as described by P POSSUM scoring were studied. Complications and death rates were noted. Accuracy of the mortality score of P POSSUM was determined by comparison of death rates by mann whitney test. Chi square test and fischers exact test were used to find out the significant risk factors contributing to mortality. ROC curve plotting was done and analysed to obtain a cut off range beyond which mortality can be predicted. Results: mann whitney test was done to find out the accuracy of the predicted mortality by the scoring system. the mortality score was found to be significant statistically in predicting the observed death and complications.( p- 0.0004 for mortality ). In all the risk factors studied, a positive correlation was found between higher possum score and mortality. A threshold score for predicting mortality was also calculated and a cut off was obtained. Interpretation and conclusion: Portsmouth POSSUM scoring system serves as a good predictor of post operative mortality in major general surgical procedures and was applicable even in our setup and be used for comparing various treatment modalities and assessing the quality of care provided. A cut off range in the mortality score was also obtained to serve as a predictor of post operative mortality in the said cases.
Authors and Affiliations
Airind Mathai, K. R. Bhagavan, Shishira R
Keywords
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- EP ID EP592301
- DOI 10.9790/0853-1602063340.
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