Anuar, Abdul Hadi
(2017)
The value of POSSUM and P-POSSUM as surgical audit tool predicting morbidity and mortality in emergency laparotomy : retrospective review in HUSM 2012-2015.
Masters thesis, Universiti Sains Malaysia.
Abstract
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.
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