J Korean Surg Soc.  2009 Dec;77(6):391-398. 10.4174/jkss.2009.77.6.391.

Validation of POSSUM-physiological Score as Predictors of Post-operative Morbidity and Mortality after Emergency Operation for Peptic Ulcer Complications

• Kim HB
• Ahn HS
• Kwon JS
• Jung IM
• Ahn YJ
• Heo SC
• Hwang KT
• Chung JK

• KMID: 1464818
• DOI: http://doi.org/10.4174/jkss.2009.77.6.391

Abstract

PURPOSE
The POSSUM (Physiological and Operative Severity Score for Enumeration of Mortality and Morbidity) score was developed to predict post-operative mortality and morbidity rates. The aim of this study was to validate the POSSUM physiologic score (POSSUM-P) in emergent operations for peptic ulcer complications.
METHODS
We retrospectively collected data on patients who underwent emergent operation for peptic ulcer complications at Boramae Hospital between January 2003 and April 2009. The data included patients' characteristics (underlying disease, medication, duration of symptoms), operative characteristics (operation method, morbidity, and mortality) and the items for the POSSUM-P (basic information (age, sex, etc.), circulatory and respiratory signs, electrocardiogram, blood pressure, hemoglobin, white blood cell count, potassium level, sodium level, urea level and Glasgow coma scale). The POSSUM-P was calculated and compared according to the morbidity and mortality.
RESULTS
One hundred and twelve patients were included. As for operation methods, primary repair (48.2%) was most common, followed by truncal vagotomy with pyloroplasty (27.7%). Thirty-seven patients had morbidities including wound infections (20), pneumonias (14), fluid collections (9), and so on. Eight patients died due to sepsis or pulmonary edema. The means of POSSUM-P were significantly different between patients with and without mortality (37.8 vs. 19.2, P<0.001) and between patients with and without morbidity (26.7 vs. 17.3, P<0.001). Those were different between patients with and without postoperative pneumonia and wound infection (P=0.002 and P=0.029, respectively).
CONCLUSION
The POSSUM physiologic score could help to predict the mortality or morbidity after emergency operation for complications of peptic ulcer disease, especially postoperative pneumonia or wound infection.

Keyword

POSSUM; Mortality; Morbidity; Peptic ulcer complications

MeSH Terms

Blood Pressure
Coma
Electrocardiography
Emergencies
Hemoglobins
Humans
Leukocyte Count
Peptic Ulcer
Pneumonia
Potassium
Pulmonary Edema
Retrospective Studies
Sepsis
Sodium
Urea
Vagotomy, Truncal
Wound Infection
Hemoglobins
Potassium
Sodium
Urea

Figure

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  Fig. 1 Hospital stay according to the POSSUM-phys score.

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