POSSUM System In Predicting Morbidity and Mortality In Emergency Laparotomy Cases

Syeda Alisha Fatima Rizvi, Aisha Gul, Muhammad Usman Khan, Akram Rajput, Erum Anwer, Raheel Ahmad

Abstract

Objective

To predict the morbidity and mortality in patients planned for emergency laparotomy procedure by utilizing physiological and operative severity score for the enumeration of morbidity and mortality (POSSUM) system.

Study design

Observational cross sectional study.

Place & Duration of study

Department of Surgery, Dow University of Health Sciences  / Ruth Pfau Civil Hospital Karachi and Surgical Assessment Unit Shaheed Mohtarma Benazir Bhutto (SMBB) Institute of Trauma Karachi, from November 2021 to May 2023.

Methods

All patients between 15 years - 75 years of age who underwent emergency laparotomy were included. The POSSUM system was used to predict 30-days morbidity and mortality. Data were entered into the SPSS 23 and analyzed. Receivers operating curve (ROC) was computed to determine the discrimination ability of POSSUM system for predicting morbidity and mortality.

Results

A total of 200 patients were included in this study. Mean age of the patients was 28.72±13.89 years. Majority (n=163 - 81.5%) of the patients were males. The 30-days morbidity and mortality rates were 34.5% (n=69) and 7.0% (n=14) respectively. However, the area under curve (AUC) of POSSUM morbidity and mortality score was 0.540 and 0.796 respectively. It was statistically significant for mortality score only.

Conclusion

A weak discrimination ability of POSSUM morbidity score in predicting 30-days morbidity was found. However, POSSUM mortality score showed good discrimination ability in patients who underwent emergency laparotomy.

Key words

Peritonitis, Emergency laparotomy, Morbidity, Mortality, POSSUM system.