title: Validation of the use of POSSUM score in enteric perforation peritonitis - results of a prospective study.
abstract: BACKGROUND
  The objective of the study was to present our last 5-years experience of peritonitis and validate POSSUM score in predicting mortality and morbidity in patients of enteric perforation (EP) peritonitis.
  
  
  METHODS
  Data was collected prospectively for all peritonitis cases admitted in single surgical unit from January 2005 to December 2009. Parameters for calculating POSSUM were also retrieved; in these patients, O:E (Observed vs. Expected) ratio of mortality and morbidity were estimated after calculating predicted mortality and morbidity by exponential regression equations.
  
  
  RESULTS
  887 patients with peritonitis were admitted and treated in this unit during the 5 years of study period. Duodenal (n=431; 48%) followed by ileal (n=380; 42.8%) perforations were the commonest. Mean age of the patients was 34 years and 86% were males. Mean delay in presentation was 78.5 hrs. Mean duration of hospital and ICU stay was 13 and 7.2 days. Postoperative complications were seen in 481 (54%) patients, and 90 (10%) patients died. POSSUM scores and predicted mortality/morbidity were calculated in 380 patients of ileal perforation peritonitis; O:E ratio of mortality and morbidity were 0.47 and 0.85 in these patients.
  
  
  CONCLUSIONS
  POSSUM and P-POSSUM are accurate tools for predicting morbidity and mortality respectively in EP patients. Though they may sometime over or under predict morbidity as well as mortality.
authors.affiliation: Department of Surgery, University College of Medical Sciences and associated Guru Teg Bahadur Hospital, New Delhi-110095, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Kumar
authors.forename: Amit
authors.initials: A
authors.lastname: Gupta
authors.forename: Sujata
authors.initials: S
authors.lastname: Chaudhary
authors.forename: Neeraj
authors.initials: N
authors.lastname: Agrawal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007416:Intestinal Perforation / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D019370:Observation; D010538:Peritonitis / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D011183:Postoperative Complications; D011446:Prospective Studies; D015203:Reproducibility of Results; D018570:Risk Assessment; D012720:Severity of Illness Index; D055815:Young Adult