POSSUM scoring in hollow viscus perforation at National Medical College and Teaching Hospital, Nepal
DOI:
https://doi.org/10.18203/2349-2902.isj20233671Keywords:
Hollow viscus perforation, POSSUM score, Mortality, Morbidity, PeritonitisAbstract
Background: Peritonitis as a result of hollow viscus perforation is a common condition in developing countries like Nepal where post-operative period is unpredictable even if patient reaches hospital in time and being operated. Physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) helps to identify patients at increased risk of developing deaths and complications. It is based on 12 physiological and 6 operative parameters.
Methods: A total of 50 patients of hollow viscus perforation admitted and operated at National Medical College and Teaching Hospital Birgunj, Nepal from July 2020 to June 2021 were included in study. It was a prospective observational study.
Results: During the study 9 patients died and the observed to expected ratio (O: E) 0.3 was obtained. Out of 41 patients who survived 28 suffered complications an observed to expected ratio (O: E) of 0.68 was obtained.
Conclusions: POSSUM scoring system is reliable for predicting post-operative morbidity and mortality and helps to improve prognosis of patients operated for perforated hollow viscus.
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References
Mohil RS, Bhatnagar D, Bahadur L, Rajaneesh, Dev DK, Magan M. POSSUM and P-POSSUM for risk-adjusted audit of patients undergoing emergency laparotomy. Br J Surg. 2004;91:500-3.
Farthman EH, Schoffel U. Principles and limitations of operative management of intra-abdominal infections. World J Surg. 1990;14;210.
Whittmann DH, Walker AP, London RE. Peritonitis and intra-abdominal infection. Principles of Surgery by Schwartz. 6th edition. McGraw Hill. 1999;1449-80.
Zinner MJ, Bennion RS. Peritonitis and Intra-abdominal abscess. Maingot’s abdominal operations. 10th edition. Appleton and Lange A Simon and Schuster Company. 1997;633-50.
Bharti SV, Mishra SM, Ranjitkar RR, Chhetri AO. Efficacy of Possum in Surgical Audit of Patient Undergoing Emergency Surgery at Nepalgunj Medical College. J Nepalgunj Med Coll. 2016;14(2):2-7.
Gupta S, Kaushik R. Peritonitis–the Eastern experience. World J Emerg Surg. 2006;1(1):1-6.
Morgan GE, Mikhail MS, Murray MJ, Larson CP. Pre-operative physical status classification of patients according to the American Society of Anesthesiologists. Clin Anesthesiol. 3rd Edition. 2021;8.
Knaus WA, Wagner DP, Draper EA, Zimmerman JE, Bergner M, Bastos PG, et al. The APACHE III prognostic system. Risk prediction of hospital mortality for critically ill hospitalized adults. Chest. 1991;100(6):1619-36.
Goldman L, Caldera DL, Nussbaum SR, Southwick FS, Krogstad D, Murray B, et al. multifactorial index of cardiac risk in noncardiac surgical procedures. N Engl J Med. 1977;297(16):845-50.
Kitara DL, Kakande I, Mugisa BD. POSSUM scoring system in patients undergoing laparotomy in Mulago Hospital. East Central Afr J Surg. 2007;12(2):133-42.
Gurjar S, Jain S, Kansal A, Prakash A. Study of POSSUM Score for Risk Assessment in Patients of Perforation Peritonitis at a Tertiary Care teaching hospital. Int J Health Clin Res. 2021;4(9):99-105.
Copeland GP, Jones D, Walters M. POSSUM: a scoring system for surgical audit. Br J Surg 1991;78(3):355-60
Sagar PM, Hartley MN, Mancey-Jones B, Sedman PC, May J, Macfie J. comparative audit of colorectal resection with the POSSUM scoring system. Br J Surg. 1994;81:1492-4.
Copeland GP, Jones DR, Wilcox A, Harris PL. comparative vascular audit using the POSSUM scoring system. Ann R Coll Surg Engl. 1993;75:175-7.
Chatterjee AS, Renganathan DN. POSSUM: a scoring system for perforative peritonitis. Journal of clinical and diagnostic research: JCDR. 2015;9(4):PC05.
Batra P, Batra R, Utaal MS. Possum scoring system for predicting prognosis in patients of perforation peritonitis. Int Surg J. 2016;3(4):2115-9.
Vishwani A, Gaikwad VV, Kulkarni RM, Murchite S. Effi cacy of Possum Scoring System in Predicting Mortality and Morbidity in Patients of Peritonitis Undergoing Laparotomy. Int J Scientific Study. 2014;2(4):29-36.
Kumar S, Gupta A, Chaudhary S, Agrawal N. Validation of the use of POSSUM score in enteric perforation peritonitis - results of a prospective study. Pan Afr Med J. 2011;9:22.
Mohil RS, Bhatnagar D, Bahadur L, Rajaneesh, Dev DK, Magan M. POSSUM and P-POSSUM for risk-adjusted audit of patients undergoing emergency laparotomy. Br J Surg. 2004;91:500-3.
Yii MK, Ng KJ. Risk-adjusted surgical audit with the POSSUM scoring system in a developing country. J Br Surg. 2002;89(1):110-3.
