PREDICTORS OF POST OPERATIVE MORTALITY AND MORBIDITY USING THE PPOSSUM SCORING SYSTEM IN GENERAL SURGICAL PATIENTS

Abstract

Introduction: The risk scoring system in all elds of medicine is gaining popularity in order to assess the outcome and improve the patient care. Various scoring systems are available to predict the surgical outcome, but most of them fail to incorporate surgical factors. Portsmouth Physiological and Operative Severity Scores for the enumeration of Mortality and Morbidity (P-POSSUM) scoring system help in predicting the outcome in the surgical patients. This study was conducted to evaluate the validity of P- POSSUM in patients undergoing major surgery and to enumerate the risk factors for low outcome in our setup. Methods: A longitudinal observational study on 250 consenting patients who underwent medium, major and major + surgeries as dened by POSSUM scoring system. Data was collected as per 12 physiological and 6 operative factors to obtain P-POSSUM scores and statistical analysis was done to compare the actual and predicted mortality. Result: The predicted mortality score was statistically signicant in predicting the death (p- 0.0004). Among all the risk factors studied, 12 physiological and the 5 operative parameters had a signicant contribution towards predicting the post operative mortality. A threshold score beyond which the mortality can be predicted was also obtained by plotting the ROC curve. Conclusion: This study validates P-POSSUM scoring system accurately in predicting mortality in patients who underwent major surgical procedures in our setup and helped in identifying the factors responsible for the poor outcome.