Affiliation:
1. Dept. of General Surgery, Senior Resident, KS Hegde Medical Academy, NITTE (deemed to be) University, Mangalore, Karnataka, India
2. Dept of General Surgery, Professor, Father Muller Medical College, Mangalore, Karnataka, India
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 dened 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 signicant in predicting the death (p- 0.0004). Among all the risk factors studied, 12 physiological and the 5 operative parameters
had a signicant 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.
Subject
Clinical Biochemistry,Molecular Biology,Molecular Medicine,Biochemistry,Clinical Biochemistry,Molecular Biology,Pathology and Forensic Medicine,Cancer Research,Immunology and Microbiology (miscellaneous),General Medicine,Cell Biology,Toxicology,General Medicine,Pathology and Forensic Medicine,Cognitive Neuroscience,Neuroscience (miscellaneous),General Veterinary,General Biochemistry, Genetics and Molecular Biology,Animal Science and Zoology,General Medicine,Space and Planetary Science,Astronomy and Astrophysics,General Biochemistry, Genetics and Molecular Biology,General Neuroscience,Cell Biology