Assessment of morbidity and mortality by P-POSSUM scores in Emergency GI Surgeries

Background: Assessment of morbidity and mortality risk in emergency gastrointestinal surgeries is a fairly difficult challenge. To have a better scientific, reliable, and reproducible method of assessment POSSUM and its modified version PPOSSUM scores have been devised. In this study, we tried to evaluate the P-POSSUM Scores in patients undergoing emergency GI surgical procedures. Methods: This study was done in the Department of General Surgery, PIMS a tertiary care hospital. Consecutive emergency surgical procedures following inclusion and exclusion criteria were selected for the study. A total of n=50 cases were included in the study. P-POSSUM scores were derived for each of the cases and analysis of the predicted morbidity and mortality was compared. Results: The range of 9.9% risk was done to categorize into 10 different groups with increasing order of scores. The highest frequency was observed in 20.1 – 30.0% which was 22% lower frequency scores were observed in higher extremes. The morbidity risk scores show the highest frequency in 32% in the range of > 90.0 cases followed by 80.1 – 90.0 having cases of 28%. Conclusion: P-POSSUM is an accurate and reliable scoring method for assessing morbidity and mortality in emergency Gastrointestinal surgeries. However, it was found to overestimate mortality and morbidity in our patient population. P-POSSUM over-estimates risk for morbidity in lowrisk groups w