Indentifying Risk Factor for Low out Come in General Surgical Practice Using Portsmouth Possum Scoring System

Abstract

BACKGROUND AND OBJECTIVES: The aim of the present study was to compare the outcome of various surgical modalities using the Physiological and Operative Severity Score for the enumeration of Mortality and morbidity (POSSUM) and its modification the Portsmouth POSSUM. It should be quick and easy to use and should be applicable to all general surgical procedure in both the emergency and elective situation. It should be of use in all type of hospital and should provide educational information. In this prospective study, the validity of P-POSSUM was test in patient undergoing for major surgery and identifying the risk factor for low out come were noted. METHODS: Prospective study on 75 patients undergoing major surgeries both in emergency and elective sitting .The disease severity was assessed in all patient using P-POOSUM scoring system. Predicted post operative mortality rates was calculated using the P-POSSUM equation by linear analysis method. It was then compared with the actual out comes and also the risk factors as scored in the possum criteria were noted. RESULTS: By Applying linear analysis, an observed to expected ratio of 0.96 was obtained this indicating a significant fit for predicting the post operative adverse outcome. There was no significant difference between the observed and predicted mortality rates (x2 = 1.667, 9 d.f.,P = 0.9957). It was found to be comparable to other studies. In all the risk factors studied, a positive correlation was found between deaths and higher POSSUM scores. INTERPRETATION AND CONCLUSION: To conclude, the present study suggest that the out come of surgical patients is reasonably good. Portsmouth POSSUM scoring system serves as a good predictor of post operative outcome in major general surgical procedures and was applicable even in our setup and be used for comparing various treatment modalities and assessing the quality of care provided.