Mortality in Patients Undergoing Emergency Laparotomy and its comparison with Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity Scoring

Abstract

Objective: To evaluate the role of physiological and operative severity score for the enumeration of mortality and morbidity in predicting mortality in patients undergoing emergency laparotomy. Study Design: Prospective Comparative study. Place and Duration of Study: General Surgical Ward 1 and 2, Combined Military Hospital, Rawalpindi, from Jan to Aug, 2018. Methodology: Adult patients between 12 and 60 years of age admitted from Emergency Department in Surgical ward who underwent emergency laparotomy within 48 hours of admission were enrolled in the study. Physiological and operative scores were measured for Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity and predicted mortality calculated. Patients were stratified into three groups according to the predicted mortality. Patients were then followed up 30 days post-operatively and mortality noted. Observed to predicted (O:P) mortality was calculated. Results: A total of 94 patients were enrolled out of which 85 were followed up. All patients were male with a mean age of 56.5±16 years. Most common indication for surgery was intestinal obstruction and gut perforation. Mean duration of admission was 7.97±3.5 days. Out of 85 patients 13 patients died within 30 days of surgery which equals a crude mortality rate of 15.2%. Observed to predicted mortality ratio (O:P) was 0.65. Conclusion: Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity slightly overpredicted the mortality in or study. Still it is a useful tool in risk stratification of patients according to expected outcome and...