Abstract
EVALUATION OF P - POSSUM SCORING SYSTEM IN PATIENTS UNDERGOING EMERGENCY LAPAROTOMY IN BPKIHS

*Rupesh Prasad Sah, Pawan Upadhya Sapkota, Vijay Shrestha, Suresh Prasad Sah, Rakesh Kumar Gupta

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. Methods: This is the Prospective Study and was conducted in Department of surgery of a tertiary level hospital. The study period was from February 2021 – July 2021 for 6 months. Patients admitted under department of general surgery scheduled to undergo emergency laparotomy were included and scored according to their physiological and operative findings using a proforma sheet. Patients were followed-up for the first 30 days postoperative period. The observed mortality rate was compared with the P-POSSUM predicted mortality rate. Results: A total of 60 patients who met the inclusion criteria were included in this study. On applying linear analysis, an observed to expected ratio was obtained, indicating a significant fit for predicting the post-operative adverse outcome. There was no significant difference between the observed and predicted mortality rates (x2 = 12.754, df= 9, P = 0.174). In all the risk factors studied except malignancy, pulse rate, respiratory system and the age of the patients, a positive correlation was found between deaths and higher POSSUM scores. Conclusion: Portsmouth POSSUM scoring system serves as a good predictor of post-operative outcome in emergency laparotomy procedures.

Keywords: POSSUM; surgical scoring; mortality.


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