The value of POSSUM and P-POSSUM as surgical audit tool predicting morbidity and mortality in emergency laparotomy : retrospective review in HUSM 2012-2015

• Main Author: Anuar, Abdul Hadi
• Format: Thesis
• Language: English
• Published: 2017
• Subjects: RC799-869 Diseases of the digestive system. Gastroenterology
• Online Access: http://eprints.usm.my/44521/

Emergency laparotomy is a surgical procedure of gastrointestinal tract which is potentially life threatening condition that requires prompt investigation and management. It is associated with high rates of morbidity and mortality worldwide. The factors that are responsible for poor outcome are the biological mechanism and quality of surgical care provided. Surgical audit can improve the outcome of this high risk surgery. Risk-adjusted analysis is a widely used in surgical audit. Collecting a risk-adjusted data analysis will provide information that allows identification of area where improvement needed to be made. Various risk prediction model have been developed as surgical audit tool. In United Kingdom (UK), Physiology and Operative Severity Score for the enUmeration of Mortality (POSSUM) and The Portsmouth Physiology and Operative Severity Score for the enUmeration of Mortality (P-POSSUM) risk prediction models are utilized as surgical audit tool for continuous auditing of emergency laparotomy surgery. POSSUM risk prediction models requires physiological and operative parameters to predict the likelihood of a surgical morbidity and mortality. It compares the expected outcome against the observed outcome of the surgery according to the patient risk stratification. Risk-adjusted analysis thus reflects a fair comparative surgical audit. Many studies have validated POSSUM as risk prediction models. However, there are only few POSSUM risk prediction models for emergency laparotomy. The objective of this study is to examine POSSUM and P-POSSUM as surgical audit tools predicting morbidity and mortality in emergency laparotomy in a single tertiary center which possibly valuable to be incorporated into local surgical audit practice.