EVALUATION AND OUTCOME OF EMERGENCY GIT SURGERIES

Abstract

Background: Emergency gastrointestinal surgeries are frequently performed procedure which have mortality and morbidity much more than that of elective surgery, they carry a substantial risk of operative and postoperative complications and death. A system was developed to allow for the rst time an assessment of surgical quality that was risk adjusted for the patient's acute and chronic physiological status and for the nature of operation. The POSSUM audit system was designed to be easy and rapid to use and to have wide application across the general surgical spectrum both in the elective and emergency settings. Our study was conducted on 96 Pat Methods: ients of acute abdomen and blunt injury undergoing emergency GIT surgery and patients which develop postoperative complications admitted in department of surgery, RD Gardi Medical College,Ujjain between November 2018 to April 2020 Our study Signies that Forty-thre Results: e percent patients had morbidity in these group of patients, among which wound related complication has the predominant cause of morbidity, pulmonary complication were also common. In total eight patients died in patients undergoing emergency laparotomy four because of of MODS three due to SIRS and one due to sepsis. In our study, ve patients had cardiac risk . Respiratory signs were more prevalent seventeen patients having them, Blood loss was also higher with eleven patients having more than 1000 ml blood loss. Peritoneal soiling was also very common, with thirty seven patients having localised pus collections in forty-one, spillage of bowel contents seen in seventeen patients and hemoperitoneum in four patients Recognizing Conclusions. patients who are at high risk to develop complications and who have high risk of mortality would prompt us to take necessary and timely action and aid us in the better management of the patient. POSSUM mortality equation over predicts mortality especially in low risk groups, while predictive value improves signicantly when exponential analysis is used.Hence POSSUM scoring system has an undeniable advantage in our set up for better patient counseling, improving the surgical outcomes in emergency wards and for better management of limited resources and manpower.