title: Portsmouth physiological and operative severity score for the Enumeration of Mortality and morbidity scoring system in general surgical practice and identifying risk factors for poor outcome.
abstract: BACKGROUND
  Estimation of the outcome is paramount in disease stratification and subsequent management in severely ill surgical patients. Risk scoring helps us quantify the prospects of adverse outcome in a patient. Portsmouth-Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (P-POSSUM) the world over has proved itself as a worthy scoring system and the present study was done to evaluate the feasibility of P-POSSUM as a risk scoring system as a tool in efficacious prediction of mortality and morbidity in our demographic profile.
  
  
  METHODS
  Validity of P-POSSUM was assessed prospectively in fifty major general surgeries performed at our hospital from May 2011 to October 2012. Data were collected to obtain P-POSSUM score, and statistical analysis was performed.
  
  
  RESULTS
  Majority (72%) of patients was male and mean age was 40.24 ± 18.6 years. Seventy-eight percentage procedures were emergency laparotomies commonly performed for perforation peritonitis. Mean physiological score was 17.56 ± 7.6, and operative score was 17.76 ± 4.5 (total score = 35.3 ± 10.4). The ratio of observed to expected mortality rate was 0.86 and morbidity rate was 0.78.
  
  
  CONCLUSIONS
  P-POSSUM accurately predicted both mortality and morbidity in patients who underwent major surgical procedures in our setup. Thus, it helped us in identifying patients who required preferential attention and aggressive management. Widespread application of this tool can result in better distribution of care among high-risk surgical patients.
authors.affiliation: Department of Surgery, Saraswathi Institute of Medical Sciences, Hapur, Uttar Pradesh, India.
authors.forename: Ashish
authors.initials: A
authors.lastname: Tyagi
authors.affiliation: Department of Surgery, GGS Medical College, Faridkot, Punjab, India.
authors.forename: Nitin
authors.initials: N
authors.lastname: Nagpal
authors.affiliation: Department of Surgery, GGS Medical College, Faridkot, Punjab, India.
authors.forename: D S
authors.initials: DS
authors.lastname: Sidhu
authors.affiliation: Department of Surgery, GGS Medical College, Faridkot, Punjab, India.
authors.forename: Amandeep
authors.initials: A
authors.lastname: Singh
authors.affiliation: Department of ENT, Saraswathi Institute of Medical Sciences, Hapur, Uttar Pradesh, India.
authors.forename: Anjali
authors.initials: A
authors.lastname: Tyagi
keywords: Portsmouth-Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity; risk scoring; surgical audit