An observational study to assess effectiveness of POSSUM and P-POSSUM score for prediction of morbidity and mortality after surgery for ileal perforation

Abstract

Abstract Background: Perforative peritonitis is the most common surgical emergency. Most common perforation is seen in ileum, followed by duodenum, stomach, appendix, jejunum and colon. The methods of source control for ileal perforations include primary closure, resection, and anastomosis of small gut or diverting stoma, depending on the site and number of perforations, severity of peritonitis, and general condition of the patient. This study aims to assess the effectiveness of the POSSUM and P-POSSUM score in predicting morbidity and mortality following surgery for ileal perforation. And evaluate the correlation between the physiological factors and operative findings leading to morbidity and mortality for ileal perforation. Method: The study included all cases of ileal perforation undergoing surgery. Predicted morbidity and mortality scores were calculated based on physiologic and Operatives cores using POSSUM & P-POSSUM equations. Result: A total 40 patients were included in present study. Mean POSSUM morbidity was 95.45, while mean POSSUM mortality was 69.28. Significant association was found between physiological and operative score with fair correlation. Expected morbidity and mortality determined by POSSUM score showed values significantly above the observed ones. P-POSSUM score systems was effective in predicting mortality. Conclusion: POSSUM and P-POSSUM score can be used as good stratification tool for predicting morbidity and mortality in cases of ileal perforation respectively.