A prospective study of risk stratification in patients undergoing emergency laparotomy with POSSUM and P-POSSUM

Jain, Ajay K.; Sharma, Dhiraj

doi:10.18203/2349-2902.isj20160227

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…Our findings are in line with. 38,14 were it was reported that P-POSSUMs mortality prediction in low risk groups improves when exponential analysis is applied.…”

Section: Discussionmentioning

confidence: 99%

“…Of which Physiological and Operative Severity Score for the enumeration of Mortality and morbidity (POSSUM) proposed in 1991 is well validated scoring systems for predicting postoperative morbidity and Portsmouth modification (P-POSSUM) is well validated scoring systems for predicting 30-day post-operative mortality risk in patients undergoing general and emergency surgery. [13][14][15] A table, representing physiological and operative score for POSSUM and P-POSSUM can be found in Banu et al 16 According to Banu et al, both POSSUM and P-POSSUM scoring systems is based on same Physiological and Operative measures, use a four grade, twelve significant and independent Physiological factors which evaluate the physiological status of the patient at the time of surgery. 16 The values obtained for the physiological score (PS) can be between 12 and 88.…”

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confidence: 99%

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Comparison of P-POSSUM and E-POSSUM in defining prognosis in acute abdomen cases

Nambi

Giridharan

2019

Int Surg J

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Background: The study attempts to define prognosis in acute abdomen cases using elderly modification (E-POSSUM) and compares its performance with physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) and Portsmouth modification- (P-POSSUM).Methods: A non-randomized, prospective study was conducted between January 2016-November 2018 in 260 patients, aged ≥60 years old, undergoing elective and emergency general surgeries. Baseline characteristics, PS at the time of admission, surgery and OS at the moment of the patient’s discharge was obtained after formal ethical consent. The follow up period was 30 days post-surgery, and complications if any, were noted.Results: When exponential analysis was applied, POSSUM over predicted morbidity in low risk group (<30%), and though, it accurately predicted morbidity in higher risk strata, it was not statistically significant. Similarly, E-POSSUM accurately predicted morbidity for risk strata 60 -100 however, it was not significant when chi-square test was applied. However, when compared to POSSUM morbidity equation, E-POSSUM showed signiﬁcant difference for risk strata 40-100 and 50-100. When exponential analysis was applied, E-POSSUM accurately predicted post-operative mortality similar to P-POSSUM. However, based on observed and expected ratio, E-POSSUM outperforms P-POSSUM in prediction of mortality.Conclusions: Exponential analysis of E-POSSUM better predicts morbidity and post-operative mortality risk in various acute abdomen cases when compared to POSSUM morbidity and P-POSSUM mortality equation. Hence, E-POSSUM is a valid scoring system for predicting morbidity and mortality risk in elderly patients undergoing elective and emergency surgery for acute abdomen.

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“…Our findings are in line with. 38,14 were it was reported that P-POSSUMs mortality prediction in low risk groups improves when exponential analysis is applied.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%