The feasibility of possum scoring for the evaluation of general surgical clinics
Nurkan Törer, Kenan Çalışkan, Mehmet Haberal, Ali Ezel, Tarık Zafer Nursal
Başkent Üniversitesi Genel Cerrahi AD, ADANA
Purpose: To calculate The Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) Score of the patients who were operated in our clinic, and to evaluate the predictive value of POSSUM regarding morbidity and mortality.
Patients and Methods: Data including demographic features, type of operation, ASA and POSSUM scores, morbidity and mortality are recorded.
Results: POSSUM score was calculated for only 747 of all 1463 patients. Median age was 51 years (15–86) and 46.7% of the patients (n=349) were men. Median overall hospital stay was 2 days (0–38) and postoperative hospital stay was 1 day (0–38). Morbidity rate was 6.8% (n=51), and mortality was 0.9% (n=7). Type of operation was significantly related with both morbidity and mortality (p=0.002, p=0.006). Among the variables, Glasgow Coma Scale, hemoglobin level, operation category and ASA Score were significantly related with only morbidity. Serum urea, electrocardiogram, number of procedures and ASA Score were significantly related with mortality. Serum sodium, white blood cell count, operation category and timing of operation have a borderline significance with mortality. Mean POSSUM Score of all patients were 15.8 ± 6.2. ROC (receiver-operator characteristic) curve of POSSUM/ morbidity-mortality was analyzed and the area under curve was calculated as; 0,746±0,098 (p= 0,016) for mortality and 0,626±0,037 (p= 0,003) for morbidity.
Conclusion: POSSUM scoring system seems to be a successful method to predict morbidity and mortality. Due to practical difficulties, its use may be limited to the academical studies.
Keywords: POSSUM, morbidity, mortality