P-POSSUM Score: A Comprehensive Predictor of Mortality and Morbidity in Emergency Surgical Cases
Sunil Pudale, Sneha Grace, Vinod Prabhu
A
BSTRACT
Aim:
To study the association between the Portsmouth Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (P-POSSUM) score and the outcome in all emergency surgical cases.
Materials and Methods:
All patients above 18 years of age undergoing emergency surgical intervention were included in this study. Pediatric patients, elective surgeries, unconscious patients, and patients who were operated on outside and subsequently referred to this tertiary care hospital were excluded. The preoperative P-POSSUM score was calculated using the P-POSSUM calculator/application. The physiological score and operative score were calculated separately. Mortality was calculated for each of the above in percentage terms, and for postoperative outcomes, a combined physiological and operative score was used. Morbidity was inferred from the number of days of stay in the Intensive Care Unit (ICU).
Results:
The present study was conducted over a period of 18 months in the Department of Surgery at our tertiary care centre. A total of 100 patients were studied. Under the physiological score, the calculated cut-off value to determine the risk of death was ≥31.5, whereas the risk of death under the operative score was ≤17.5. The results showed that the risk of death can be prognosticated using both the operative and physiological scores.
Conclusion:
The P-POSSUM score predicts mortality using a comprehensive combination of physiological and surgical parameters.