Efficacy of Possum Score in Predicting the Outcome in Patients Undergoing Emergency Laparotomy
Monitoring of surgical outcome is increasingly important part of governance of surgical activity. The aim of the study. POSSUM scoring system was applied prospectively to determine how it performed in predicting morbidity and mortality in patients undergoing emergency laparotomy in our hospital, a g...
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| Veröffentlicht in: | Polski przeglad chirurgiczny 2014-04, Vol.86 (4), p.159-165 |
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| creator | Sreeharsha, Harinatha Sp, Rai Sreekar, Harinatha Reddy, Ravi |
| description | Monitoring of surgical outcome is increasingly important part of governance of surgical activity. The aim of the study. POSSUM scoring system was applied prospectively to determine how it performed in predicting morbidity and mortality in patients undergoing emergency laparotomy in our hospital, a group known to be at high risk of complications and death. Material and methods. A total of 100 cases of emergency laparotomies were studied in patients admitted in general surgery department during the period of May 2008 to August 2010. The study group consisted of the following cases. Duodenal perforation (37 cases), intestinal obstruction (27 cases), gastric perforation (8 cases), ileal perforation (8 cases), appendicular perforation (7 cases), blunt trauma (4 cases) and others (9 cases). They were scored using POSSUM scoring system. Physiological scoring was done at the time of admission and operative scoring was done intraoperatively. They were followed up for the first 30 day post operative period for any complications and the outcome was noted. The observed morbidity and mortality rates were compared with the POSSUM predicted morbidity and mortality rates. Results. 15 patients died (mortality rate of 15%). The POSSUM predicted mortality was 20 deaths. O:E ratio of 0.71 was obtained. There was no statistically significant difference between the observed and predicted mortality rates (χ2=1.72, p=0.974). 71 patients experienced complications. The POSSUM predicted morbidity was 61 patients. O:E ratio of 1.19 was obtained. There was no statistically significant difference between the observed and predicted morbidity rates (χ2=1.594, p=0.991). Conclusions. 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. POSSUM can be used for surgical audit to assess and improve the quality of surgical care and helps in better outcome to the patient |
| doi_str_mv | 10.2478/pjs-2014-0029 |
| format | Article |
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The aim of the study. POSSUM scoring system was applied prospectively to determine how it performed in predicting morbidity and mortality in patients undergoing emergency laparotomy in our hospital, a group known to be at high risk of complications and death. Material and methods. A total of 100 cases of emergency laparotomies were studied in patients admitted in general surgery department during the period of May 2008 to August 2010. The study group consisted of the following cases. Duodenal perforation (37 cases), intestinal obstruction (27 cases), gastric perforation (8 cases), ileal perforation (8 cases), appendicular perforation (7 cases), blunt trauma (4 cases) and others (9 cases). They were scored using POSSUM scoring system. Physiological scoring was done at the time of admission and operative scoring was done intraoperatively. They were followed up for the first 30 day post operative period for any complications and the outcome was noted. The observed morbidity and mortality rates were compared with the POSSUM predicted morbidity and mortality rates. Results. 15 patients died (mortality rate of 15%). The POSSUM predicted mortality was 20 deaths. O:E ratio of 0.71 was obtained. There was no statistically significant difference between the observed and predicted mortality rates (χ2=1.72, p=0.974). 71 patients experienced complications. The POSSUM predicted morbidity was 61 patients. O:E ratio of 1.19 was obtained. There was no statistically significant difference between the observed and predicted morbidity rates (χ2=1.594, p=0.991). Conclusions. 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. POSSUM can be used for surgical audit to assess and improve the quality of surgical care and helps in better outcome to the patient</description><identifier>ISSN: 0032-373X</identifier><identifier>EISSN: 0032-373X</identifier><identifier>EISSN: 2299-2847</identifier><identifier>DOI: 10.2478/pjs-2014-0029</identifier><identifier>PMID: 24988229</identifier><language>eng</language><publisher>Poland: De Gruyter Open</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Appendicitis - surgery ; Duodenal Diseases - surgery ; emergency laparotomy ; Emergency Medical Services - statistics & numerical data ; Female ; Hospital Mortality ; Humans ; Ileal Diseases - surgery ; India ; Intestinal Obstruction - surgery ; Intestinal Perforation - surgery ; Laparotomy - mortality ; Laparotomy - statistics & numerical data ; Male ; Middle Aged ; Morbidity ; POSSUM scoring ; Predictive Value of Tests ; Risk Assessment ; Risk Factors ; risk stratification ; Severity of Illness Index ; Stomach Diseases - surgery ; Treatment Outcome</subject><ispartof>Polski przeglad chirurgiczny, 2014-04, Vol.86 (4), p.159-165</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2609-866be05928cc69a276bc8ca4775f68407c2cbe77a8c43d132730e727a16722273</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24988229$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sreeharsha, Harinatha</creatorcontrib><creatorcontrib>Sp, Rai</creatorcontrib><creatorcontrib>Sreekar, Harinatha</creatorcontrib><creatorcontrib>Reddy, Ravi</creatorcontrib><title>Efficacy of Possum Score in Predicting the Outcome in Patients Undergoing Emergency Laparotomy</title><title>Polski przeglad chirurgiczny</title><addtitle>Pol Przegl Chir</addtitle><description>Monitoring of surgical outcome is increasingly important part of governance of surgical activity. The aim of the study. POSSUM scoring system was applied prospectively to determine how it performed in predicting morbidity and mortality in patients undergoing emergency laparotomy in our hospital, a group known to be at high risk of complications and death. Material and methods. A total of 100 cases of emergency laparotomies were studied in patients admitted in general surgery department during the period of May 2008 to August 2010. The study group consisted of the following cases. Duodenal perforation (37 cases), intestinal obstruction (27 cases), gastric perforation (8 cases), ileal perforation (8 cases), appendicular perforation (7 cases), blunt trauma (4 cases) and others (9 cases). They were scored using POSSUM scoring system. Physiological scoring was done at the time of admission and operative scoring was done intraoperatively. They were followed up for the first 30 day post operative period for any complications and the outcome was noted. The observed morbidity and mortality rates were compared with the POSSUM predicted morbidity and mortality rates. Results. 15 patients died (mortality rate of 15%). The POSSUM predicted mortality was 20 deaths. O:E ratio of 0.71 was obtained. There was no statistically significant difference between the observed and predicted mortality rates (χ2=1.72, p=0.974). 71 patients experienced complications. The POSSUM predicted morbidity was 61 patients. O:E ratio of 1.19 was obtained. There was no statistically significant difference between the observed and predicted morbidity rates (χ2=1.594, p=0.991). Conclusions. 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. POSSUM can be used for surgical audit to assess and improve the quality of surgical care and helps in better outcome to the patient</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Appendicitis - surgery</subject><subject>Duodenal Diseases - surgery</subject><subject>emergency laparotomy</subject><subject>Emergency Medical Services - statistics & numerical data</subject><subject>Female</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Ileal Diseases - surgery</subject><subject>India</subject><subject>Intestinal Obstruction - surgery</subject><subject>Intestinal Perforation - surgery</subject><subject>Laparotomy - mortality</subject><subject>Laparotomy - statistics & numerical data</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>POSSUM scoring</subject><subject>Predictive Value of Tests</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>risk stratification</subject><subject>Severity of Illness Index</subject><subject>Stomach Diseases - surgery</subject><subject>Treatment Outcome</subject><issn>0032-373X</issn><issn>0032-373X</issn><issn>2299-2847</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkF1LwzAUhoMobk4vvZX8gWp60uUDr2RsKgw20IFXljRNZ8falDRF-u9NqYoXXuUN5-HlnAeh65jcQsLFXXNoIyBxEhEC8gRNCaEQUU7fTv_kCbpo2wMhc0lBnqMJJFIIADlF78uiKLXSPbYF3tq27Sr8oq0zuKzx1pm81L6s99h_GLzpvLbVOFG-NLVv8a7OjdvbAVlWIZk6VK1Vo5z1tuov0Vmhjq25-n5naLdavi6eovXm8XnxsI40MCIjwVhmwnYgtGZSAWeZFlolnM8LJhLCNejMcK6ETmgeU-CUGA5cxYwDhN8MRWOvduEGZ4q0cWWlXJ_GJB08pcFTOnhKB0-Bvxn5pssqk__SP2ICcD8Cn-rojcvN3nV9COnBdq4Op_xfLFgSB8lfItp3QQ</recordid><startdate>20140401</startdate><enddate>20140401</enddate><creator>Sreeharsha, Harinatha</creator><creator>Sp, Rai</creator><creator>Sreekar, Harinatha</creator><creator>Reddy, Ravi</creator><general>De Gruyter Open</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20140401</creationdate><title>Efficacy of Possum Score in Predicting the Outcome in Patients Undergoing Emergency Laparotomy</title><author>Sreeharsha, Harinatha ; Sp, Rai ; Sreekar, Harinatha ; Reddy, Ravi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2609-866be05928cc69a276bc8ca4775f68407c2cbe77a8c43d132730e727a16722273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Appendicitis - surgery</topic><topic>Duodenal Diseases - surgery</topic><topic>emergency laparotomy</topic><topic>Emergency Medical Services - statistics & numerical data</topic><topic>Female</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Ileal Diseases - surgery</topic><topic>India</topic><topic>Intestinal Obstruction - surgery</topic><topic>Intestinal Perforation - surgery</topic><topic>Laparotomy - mortality</topic><topic>Laparotomy - statistics & numerical data</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>POSSUM scoring</topic><topic>Predictive Value of Tests</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>risk stratification</topic><topic>Severity of Illness Index</topic><topic>Stomach Diseases - surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sreeharsha, Harinatha</creatorcontrib><creatorcontrib>Sp, Rai</creatorcontrib><creatorcontrib>Sreekar, Harinatha</creatorcontrib><creatorcontrib>Reddy, Ravi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Polski przeglad chirurgiczny</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sreeharsha, Harinatha</au><au>Sp, Rai</au><au>Sreekar, Harinatha</au><au>Reddy, Ravi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of Possum Score in Predicting the Outcome in Patients Undergoing Emergency Laparotomy</atitle><jtitle>Polski przeglad chirurgiczny</jtitle><addtitle>Pol Przegl Chir</addtitle><date>2014-04-01</date><risdate>2014</risdate><volume>86</volume><issue>4</issue><spage>159</spage><epage>165</epage><pages>159-165</pages><issn>0032-373X</issn><eissn>0032-373X</eissn><eissn>2299-2847</eissn><abstract>Monitoring of surgical outcome is increasingly important part of governance of surgical activity. The aim of the study. POSSUM scoring system was applied prospectively to determine how it performed in predicting morbidity and mortality in patients undergoing emergency laparotomy in our hospital, a group known to be at high risk of complications and death. Material and methods. A total of 100 cases of emergency laparotomies were studied in patients admitted in general surgery department during the period of May 2008 to August 2010. The study group consisted of the following cases. Duodenal perforation (37 cases), intestinal obstruction (27 cases), gastric perforation (8 cases), ileal perforation (8 cases), appendicular perforation (7 cases), blunt trauma (4 cases) and others (9 cases). They were scored using POSSUM scoring system. Physiological scoring was done at the time of admission and operative scoring was done intraoperatively. They were followed up for the first 30 day post operative period for any complications and the outcome was noted. The observed morbidity and mortality rates were compared with the POSSUM predicted morbidity and mortality rates. Results. 15 patients died (mortality rate of 15%). The POSSUM predicted mortality was 20 deaths. O:E ratio of 0.71 was obtained. There was no statistically significant difference between the observed and predicted mortality rates (χ2=1.72, p=0.974). 71 patients experienced complications. The POSSUM predicted morbidity was 61 patients. O:E ratio of 1.19 was obtained. There was no statistically significant difference between the observed and predicted morbidity rates (χ2=1.594, p=0.991). Conclusions. 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. POSSUM can be used for surgical audit to assess and improve the quality of surgical care and helps in better outcome to the patient</abstract><cop>Poland</cop><pub>De Gruyter Open</pub><pmid>24988229</pmid><doi>10.2478/pjs-2014-0029</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Appendicitis - surgery Duodenal Diseases - surgery emergency laparotomy Emergency Medical Services - statistics & numerical data Female Hospital Mortality Humans Ileal Diseases - surgery India Intestinal Obstruction - surgery Intestinal Perforation - surgery Laparotomy - mortality Laparotomy - statistics & numerical data Male Middle Aged Morbidity POSSUM scoring Predictive Value of Tests Risk Assessment Risk Factors risk stratification Severity of Illness Index Stomach Diseases - surgery Treatment Outcome |
| title | Efficacy of Possum Score in Predicting the Outcome in Patients Undergoing Emergency Laparotomy |
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