[The POSSUM scoring system: an instrument for measuring quality in surgical patients].
BACKGROUND
The POSSUM scale (Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity) is a scoring system that is used to predict risk-adjusted mortality and morbidity rates in a wide variety of surgical procedures. In this prospective study, the validity of the POSSUM scale was evaluated in patients undergoing laparotomy in a general surgery department.


METHODS
The POSSUM scale was prospectively applied in all patients undergoing elective and emergency laparotomy in the general surgery department of a level II hospital over 8 months. A total of 105 patients were included, of which 24 underwent emergency laparotomy and 81 underwent elective surgery. Predicted mortality and morbidity rates were calculated by using the POSSUM scale. These results were compared with actual outcomes by using Fisher's test.


RESULTS
The mean physiological score was 23.4 points (range: 12-40 points), while the mean surgical score was 11.3 points (range: 6-24 points). Three patients died during the postoperative period and 47 had morbidity. When the observed results for mortality were compared with those predicted by the POSSUM scoring system, no significant differences were observed in the analysis by risk groups, except in the risk group < 20 %, in which the POSSUM scale overestimated mortality. The risk of morbidity was underestimated by the POSSUM scale in the risk group < 20 %.


CONCLUSIONS
The POSSUM scoring system is a useful predictor of morbidity and mortality in patients undergoing emergency and elective laparotomy.
Campillo-Soto
Alvaro
A
Servicio de Cirugía General y Digestiva. Hospital General Universitario J.M. Morales Meseguer. Murcia. España. alvaroalcubo@yahoo.es
Flores-Pastor
Benito
B
Soria-Aledo
Víctor
V
Candel-Arenas
Marife
M
Andrés-García
Bruno
B
Martín-Lorenzo
Juan Gervasio
JG
Aguayo-Albasini
José Luis
JL
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003627:Data Interpretation, Statistical; D017558:Elective Surgical Procedures; D004630:Emergencies; D005260:Female; D015600:Glasgow Coma Scale; D017052:Hospital Mortality; D006801:Humans; D007813:Laparotomy / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012720:Severity of Illness Index; D016896:Treatment Outcome