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Mortality and Morbidity Prediction of P-POSSUM in Open Abdominal Surgeries

Suresh N. Huchchannavar, Assistant Professor, Department of Surgery, Karnataka Institute of Medical Sciences, Hubli-580021, Karnataka, India. , Suresh N. Huchchannavar* , Gurushantappa Yalagachin** , Lingaraj Kadadi*** , Prashant Raman*** , Avinash Lakha***

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New Indian Journal of Surgery 8(2):p 45-48, April - June 2017. | DOI: https://dx.doi.org/10.21088/nijs.0976.4747.8217.8

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Abstract

Objectives and Background: P-POSSUM (Physiological and operative severity score for the enumeration of mortality and morbidity) predicts mortality and morbidity in general surgical patients providing an adjunct to surgical audit. 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 pattern of referral and population. In this prospective study, P-POSSUM is applied in predicting the mortality and morbidity patients undergoing abdominal surgery.

Methods: A total of 130 abdominal surgery were performed. The mortality and morbidity was calculated using P-POSSUM equations. The estimatedrates were compared with observed rates using P-POSSUM equations. The estimated rates were compared with observed rates using both linear and exponential methods of analysis.

Results: A total of 21 deaths observed. P-POSSUM with linear method of analysis predicted deaths of 22 with O:E ratio of 0.95, whereas with exponential method it under predicted the death( 16 patients) with O:E ratio of 1.5, which was both clinically and statistically insignificant. With the linear analysis though it was clinically significant, statistically it was insignificant. On analysis of morbidity 81 patients had developed complications, with the predicted value of 86, with O:E ratio0.94, which was clinically significant but statistically insignificant.

Interpretation and Conclusion: with linear method for P-POSSUM equation, the scoring systems are valid in predicting details and complications which were comparable to observed mortality and morbidity. However, P-POSSUM scoring system with exponential method over predicted the mortality

 

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DOI: https://dx.doi.org/10.21088/nijs.0976.4747.8217.8

Keywords

P-POSSUM; Predictors; Mortality; Morbidity; Scoring. 

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