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POSSUM: A Scoring System for Perforative Peritonitis.

Ambarish S Chatterjee1, D N Renganathan2

  • 1Registrar, Department of General Surgery, Seth V.C. Gandhi & M.A. Vora Municipal General Hospital , Rajawadi, Ghatkopar (E), Mumbai- Maharashtra, India .

Journal of Clinical and Diagnostic Research : JCDR
|June 6, 2015
PubMed
Summary
This summary is machine-generated.

The POSSUM scoring system effectively predicts outcomes for perforative peritonitis patients. Adding perforation-to-operation time and co-morbidity improves risk assessment for better patient management.

Keywords:
Co-morbidityPerforation to operation time

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Area of Science:

  • Surgical outcomes research
  • Clinical scoring systems
  • Peritonitis management

Background:

  • Perforative peritonitis presents significant postoperative morbidity and mortality risks.
  • Predictive scoring systems are crucial for managing patient outcomes.
  • The POSSUM (Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity) system is a recognized tool for this purpose.

Purpose of the Study:

  • To evaluate the efficacy of the POSSUM scoring system in predicting postoperative outcomes in patients with perforative peritonitis.
  • To assess the impact of adding perforation-to-operation time and co-morbidity to the POSSUM system.
  • To identify high-risk patients for targeted management.

Main Methods:

  • A prospective study involving 50 patients with perforative peritonitis.
  • Data collection utilized the POSSUM scoring system, with added factors of perforation-to-operation time and co-morbidity.
  • Outcomes (death/alive, complicated/uncomplicated) were recorded and compared with expected results.

Main Results:

  • The POSSUM system showed an observed-to-expected ratio of 1.005 for mortality and 1.001 for morbidity.
  • No statistically significant differences were found between observed and expected mortality (p=0.316) or morbidity (p=0.792) rates.
  • Perforation-to-operation time and co-morbidity were identified as statistically significant factors influencing patient outcomes (p<0.05).

Conclusions:

  • The POSSUM scoring system is a reliable indicator of postoperative outcomes in perforative peritonitis patients.
  • The system's applicability was confirmed in the study setting.
  • Incorporating perforation-to-operation time and co-morbid status can enhance the POSSUM system for improved patient care and risk stratification.