EFFICACY OF PREDICTING THE MORTALITY AND MORBIDITY IN EMERGENCY LAPAROTOMY CASES USING POSSUM AND PPOSSUM SCORING SYSTEM

Dr. Siddhartha Sankar Bhattacharjee, Dr. Dhinesh Kumar. N

Abstract


Introduction:The Physiological and Operative Severity Score for the enumeration of Mortality and morbidity
(POSSUM) and its modification the Portsmouth POSSUM (P-POSSUM), have been proposed as a method for
standardizing patient data so that direct comparisons can be made despite differing patterns of referral and population.
In this prospective study, the validity of P-POSSUM was tested in patients undergoing emergency laparotomy and the
risk factors for low outcome were noted.
Materials and Method: Some 100 cases who underwent emergency laparotomy under surgical units at Silchar Medical
College and Hospital, Silchar. Data collected were based on hospital based prospective observational study. The study
period was from JUNE 2017 TO MAY 2018 for a period of one year. All patients admitted in surgery department of Silchar
Medical College and Hospital during the study period and meeting the inclusion and exclusion criteria will be included
in this study.
Result: A total of 100 patients who met the inclusion criteria were included in this study.From the interpretation of results
using the Hosmer and Lemeshow Test, the POSSUM score was found to be an accurate predictor of morbidity (x2 =3.694,
d.f=8) with a p- value of 0.884). As the p-value is >0.05 the POSSUM sore can be assumed to be an accurate measure of
morbidity.From the interpretation of results using the Hosmer and Lemeshow Test, the P-POSSUM score was found to be
an accurate predictor of mortality (x2 =3.100, d.f=8) with a pvalue of 0.928). As the p-value is >0.05 the P-POSSUM sore
can be assumed to be an accurate measure of mortality
Conclusion: Portsmouth POSSUM scoring system serves as a good predictor of postoperative outcome in emergency
laparotomy procedures.


Keywords


POSSUM; surgical scoring; mortality

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