Study of POSSUM Score for Risk Assessment in Patients of Perforation Peritonitis at a Tertiary Care teaching hospital

Abstract

Background: Perforation peritonitis carries considerable morbidity and mortality with the unpredictable postoperative period. Continuous audit of clinical practice is an essential part of making improvements in enhancing patient care. This warrants a scoring system that predicts the post-operative outcome. POSSUM (Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity) helps in predicting the post-operative morbidity and mortality in these patients. This study was done in our centre to evaluate the POSSUM score in our set of patients. Material and methods: This prospective observational study was performed in patients of perforation peritonitis admitted under the Department of General Surgery, Sri Aurobindo Medical College And Post Graduate Institute Indore (M.P.) from June 2018 to January 2020. A total of 92 patients were recruited. Data was collected from patients by their clinical history, examination, with appropriate investigations. Data were analysed using appropriate statistical tests.Results: Most common site of perforation was gastro-duodenal followed by ileal perforation. The most common surgical procedure performed was modified Graham’s patch repair. Most common complication was wound infection followed by wound dehiscence and anastomotic leak. Patients who had complications had higher mean POSSUM morbidity score .It was also observed that POSSUM mortality score was significantly higher in subjects who died.Conclusion: POSSUM scoring system is a good indicator of postoperative outcome in patients with perforation peritonitis and was applicable in our setup. It is useful in identifying high risk patients and give preferential care to them for better outcome