Evaluation of the validity of POSSUM and P-POSSUM score in predicting the risk of morbidity and mortality respectively in patients undergoing emergency laparotomy

Authors

  • Vivian Anandith Paul Department of General Surgery, Malla Reddy institute of Medical Sciences, Suraram main road, Hyderabad, Telangana
  • Agnigundala Anusha Department of General Surgery, Malla Reddy institute of Medical Sciences, Suraram main road, Hyderabad, Telangana
  • Alluru Sarath Chandra Department of General Surgery, Malla Reddy institute of Medical Sciences, Suraram main road, Hyderabad, Telangana

DOI:

https://doi.org/10.18203/2349-2902.isj20203968

Keywords:

Physiological score, Crude mortality rate, Linear analysis, Exponential analysis

Abstract

Background: Aim of this study is to examine the efficacy of Physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) and Portsmouth predictor modification (P-POSSUM) equations in predicting morbidity and mortality in patients undergoing emergency laparotomy, to study the morbidity and mortality patterns in patients undergoing emergency laparotomy at Malla Reddy Institute of Medical Sciences, Hyderabad.

Methods: The study was conducted for a period of 2 years from February 2018 to February 2020. 100 Patients undergoing emergency laparotomy were studied in the Department of General surgery MRIMS, Hyderabad. POSSUM and P-POSSUM scores are used to predict mortality and morbidity. The ratio of observed to expected deaths (O:E ratio) was calculated for each analysis.

Results: The study included total 100 patients, 83 men and 17 women. Observed mortality rate was compared to mortality rate with POSSUM, the O:E ratio was 0.62, and there was no significant difference between the observed and predicted values (χ²=10.79, 9 degree of freedom (df) p=0.148). Observed morbidity rates were compared to morbidity rates predicted by POSSUM, there was no significant difference between the observed and predicted values (χ²=9.89, 9 df, p=0.195) and the overall O:E ratio was 0.91. P-POSSUM predicted mortality equally well when the linear method of analysis was used, with an O:E ratio of 0.65 and no significant difference between the observed and predicted values (χ²= 5.33, 9 df, p= 0.617).

Conclusion: POSSUM and P-POSSUM scoring is an accurate predictor of mortality and morbidity following emergency laparotomy and is a valid means of assessing adequacy of care provided to the patient.

 

Author Biographies

Vivian Anandith Paul, Department of General Surgery, Malla Reddy institute of Medical Sciences, Suraram main road, Hyderabad, Telangana

Department Of General Surgery

Assistant Professor

Agnigundala Anusha, Department of General Surgery, Malla Reddy institute of Medical Sciences, Suraram main road, Hyderabad, Telangana

Department Of General Surgery

Assistant Professor

Alluru Sarath Chandra, Department of General Surgery, Malla Reddy institute of Medical Sciences, Suraram main road, Hyderabad, Telangana

Department Of General Surgery

Professor

References

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Published

2020-09-23

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Original Research Articles