Evaluation of POSSUM scoring in patients undergoing emergency laparotomy for hollow viscus perforation

ABSTRACT

Introduction: Crude morbidity and mortality rates are limited indicators of quality of care, and can be misleading when the results of emergency surgery are compared between different units and hospitals. Scoring systems that group patients based on the severity of illness before treatment can allow a meaningful analysis of morbidity and mortality rates. Risk-adjusted comparisons can then be made between surgeons and hospitals. The aim of the study 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. Materials and methods: Totally 100 patients who underwent emergency laparotomy from January 2015 to September 2015 at Madras Medical College and Hospital were studied. Data were collected prospectively on a pro forma prepared for the study. All patients had their physiological score recorded on admission. Results: In our study, using POSSUM score the morbidity prediction ranges from 91 – 100% morbidity rates seen in 21 patients and 31 – 40% morbidity rates seen in 22 patients. But the morbidity was observed in 63 patients out of 100. On comparing the predicted and the observed morbidity, the prediction using POSSUM and the observed morbidity was found similar. 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.