Key result
The POSSUM score demonstrated excellent predictive value for morbidity (AUC 0.945) and mortality (AUC 0.924), while the P-POSSUM score was a better predictor of mortality with an observed-to-expected ratio close to 1.
Why the study?
This study aimed to assess the effectiveness of the POSSUM and P-POSSUM scores in predicting morbidity and mortality following surgery for ileal perforation.
Do POSSUM and P-POSSUM scores accurately predict morbidity and mortality in patients undergoing surgery for ileal perforation?
Observational (n=40)
No
Do POSSUM and P-POSSUM scores accurately predict morbidity and mortality in patients undergoing surgery for ileal perforation?
Effect estimate: AUC 0.924
POSSUM and P-POSSUM scores are reliable tools for risk stratification in emergency surgery for ileal perforation, with POSSUM better for predicting morbidity and P-POSSUM better for predicting mortality.
May support risk stratification in ileal perforation surgery; leaves open prospective validation before wider adoption.
Background: Perforative peritonitis is the most common surgical emergency. Most common perforation is seen in ileum, followed by duodenum, stomach, appendix, jejunum and colon. The methods of source control for ileal perforations include primary closure, resection, and anastomosis of small gut or diverting stoma, depending on the site and number of perforations, severity of peritonitis, and general condition of the patient. This study aims to assess the effectiveness of the POSSUM and P-POSSUM score in predicting morbidity and mortality following surgery for ileal perforation. And evaluate the correlation between the physiological factors and operative findings leading to morbidity and mortality for ileal perforation. Method: The study included all cases of ileal perforation undergoing surgery. Predicted morbidity and mortality scores were calculated based on physiologic and Operatives cores using POSSUM & P-POSSUM equations. Result: A total 40 patients were included in present study. Mean POSSUM morbidity was 95.45, while mean POSSUM mortality was 69.28. Significant association was found between physiological and operative score with fair correlation. Expected morbidity and mortality determined by POSSUM score showed values significantly above the observed ones. P-POSSUM score systems was effective in predicting mortality. Conclusion: POSSUM and P-POSSUM score can be used as good stratification tool for predicting morbidity and mortality in cases of ileal perforation respectively.
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Bhat et al. (2023) conducted an observational in Ileal perforation (n=40). POSSUM and P-POSSUM scores vs. Observed outcomes was evaluated on Prediction of mortality by POSSUM score (AUC 0.924). The POSSUM score demonstrated excellent predictive value for morbidity (AUC 0.945) and mortality (AUC 0.924), while the P-POSSUM score was a better predictor of mortality with an observed-to-expected ratio close to 1.
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