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Case Studies | General Surgery | India | Volume 13 Issue 7, July 2024 | Rating: 3.7 / 10 | Rate this Article
Evaluation of Possum and P Possum Scoring Systems in Patients Undergoing Emergency Abdominal Surgeries
Dr. Sanjana GK | Dr. Shashirekha CA [2] | Dr. Krishna Prasad K [2]
Abstract: Background: Emergency abdominal surgeries are critical procedures performed urgently to address life-threatening conditions within the abdomen. These surgeries are often necessitated by acute conditions such as appendicitis, intestinal obstruction, perforated ulcers, or traumatic injuries. The goals of emergency abdominal surgeries include relieving pain, removing damaged tissue or organs, controlling bleeding, and restoring normal function to the abdomen. Recovery can vary widely depending on the severity of the condition and the patient's overall health. POSSUM (Physiological and Operative Severity Score for the enumeration of Mortality and morbidity) and its modified version P-POSSUM are scoring systems used in surgery to predict outcomes based on preoperative risk factors and intraoperative variables. P-POSSUM refines this by adjusting for overestimation biases seen in POSSUM, particularly in lower-risk patients. This study aims to evaluate the efficacy and accuracy of both scoring systems for surgical risk assessment in predicting postoperative mortality and morbidity in patients undergoing emergency abdominal surgeries. Materials and Methods: The study was approved by institutional ethical committee. We retrospectively analysed POSSUM and P-POSSUM in 75 patients undergoing emergency abdominal surgery from April 2023 to April 2024 in RL JALAPPA hospital were evaluated. Physiological scoring was done prior to surgery and operative scoring was performed intra-operatively. The observed mortality rate was then compared with POSSUM and P-POSSUM predicted mortality rates. Results: POSSUM predicted a morbidity rate of 58, whereas the actual morbidity rate was 46 (p < 0.05). PPOSSUM predicted a morbidity rate of 54, whereas the actual morbidity rate was 46 (p < 0.05). POSSUM predicted a mortality rate of 11, whereas the actual mortality rate was 10 (p < 0.05). P-POSSUM predicted a mortality rate of 13, whereas the actual mortality rate was 11 (p < 0.05). Conclusions: With a reasonably good prediction of morbidity and mortality rate, POSSUM and P-POSSUM scores are both effective scoring systems in clinical practice for use in abdominal surgery.
Keywords: Emergency Exploratory laparotomy, POSSUM, P-POSSUM
Edition: Volume 13 Issue 7, July 2024,
Pages: 477 - 480