Application of portsmouth possum scoring system in predicting morbidity and mortality of patients undergoing gastrointestinal surgery

Abstract

Background: The Physiological and Operative Severity Score for theenumeration of Mortality and morbidity (POSSUM) and its modification the Portsmouth POSSUM, have been proposed as a method for standardizing patient data so that direct comparisons can be made despite differing patterns of referral and population. Objectives: To use Portsmouth POSSUM scoring system in patients undergoing gastrointestinal surgeryfor predicting the outcome in terms of morbidity and mortality. Methods: Some 60 major gastrointestinal surgeries, as defined by the POSSUM scoring system criteriawere studied. Predicted mortality and morbidity rates were calculated using the Portsmouth POSSUM equation by linear analysis method. It was then compared with the actual outcomes. The risk factors as scored in the POSSUM criteria were noted. Results: Applying linear analysis, an observed to expected ratio of 1.14 was obtained for mortality and an observed to expected ratio of 1 was obtained for morbidity,indicating a significant fit for predicting the post-operative adverse outcome. There was nosignificant difference between the observed and predicted mortality and morbidity.  Conclusion: Portsmouth POSSUM scoring system serves as a goodpredictor of post-operative outcome in major gastrointestinal surgical procedures and was applicable even in our setup and be used for comparing various treatment modalities and assessing the quality of care provided.