Introduction: In surgery it is important to have a standard parameter to analyze outcomes, which justifies the need to develop and / or adopt instruments that can predict, as objectively as possible, the outcome of surgical treatments. The Physiological and Operative Severity Scale for the Prediction of Mortality and Morbidity (POSSUM) is a scoring system for surgical audits that fulfills these purposes. The objective of this work was to compare the morbidity and mortality presented in the patients of the General Surgery service of the HUM-Méderi who underwent abdominal surgery during the period 2015-2016 with the expected outcomes when applying the POSSUM and P-POSSUM scales. Methodology: retrospective cross-sectional study with analytical, exploratory component. The population corresponds to a representative sample of patients undergoing abdominal surgery in the period from 2015 to 2016 at the Méderi major university hospital, in the city of Bogotá, Colombia; All patients over 18 years of age who underwent surgery were included, and re-operations of patients whose first surgery was performed in another hospital center were excluded. The sample was 350 cases selected by simple random sampling. The variables used in the study were those corresponding to the physiological and operative variables of the POSSUM and P-POSSUM scales. Results: Of the 350 patients, 55.4% were women, with an average age of 55.91 years. The average physiological POSSUM score was 19.27 points. The mean operative POSSUM score was 12.85. The severity index for the sample was moderate (61.7%). Morbidity in the cohort was 14.2% with a predominance of type II and IIIB complications according to the Clavien Dindo classification. The mortality found was 7.1%. Mann Whitney U was performed comparing the results of POSSUM and P-POSSUM according to mortality with a result of 843 with a p <0.00. Pearson's correlation of the P POSSUM value and documented mortality, this being statistically significant (p = 0.000). Conclusion Mortality in our cohort does not exceed that predicted by P-POSSUM, so that its calculation in high-risk patients can be used in our service as a tool for calculating postoperative mortality.
publication date
February 17, 2021 2:52 PM
Research
keywords
Evaluation of predictive parameters of outcomes in abdominal surgery
Hit comparison of POSSUM and P-POSSUM
P-POSSUM (Portsmouth Mortality and Morbidity Severity Physiological and Operational Score)
POSSUM (Physiological and Operational Severity of Mortality and Morbidity Score)
