STUDY OF EPIDEMIOLOGY OF PERFORATIVE PERITONITIS IN A TERTIARY CARE HOSPITAL AND THE ROLE OF POSSUM SCORING IN PREDICTING OUTCOMES.

Abstract

An observational study was conducted in a tertiary care hospital to assess the efficacy of the Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity (POSSUM) scoring system to predict mortality, morbidity in patients undergoing laparotomy for perforative peritonitis from January 2016 to December 2017. 50 patients meeting the inclusion criteria were included in the study and the results were evaluated using chi-square test, P-value. Several scoring systems (eg, APACHE II, SIRS, multiple organ dysfunction syndrome [MODS],  Mannheim peritonitis index) have been developed to assess the clinical prognosis of patients with peritonitis. Most of these scores rely on certain host criteria, systemic signs of sepsis, and complications related to organ failure. Although valuable for comparing patient cohorts and institutions, these scores have limited value in the specific day-to-day clinical decision-making process for any given patient.

In our study, age group, sex ratio, presenting complaints, finding on examination, radiological finding, co-morbidities, peritoneal soiling, site of perforation, procedure performed, complications, co-relation between site of complication and perforation, morbidity and mortality rates were taken into consideration and the efficacy of POSSUM was evaluated and was compared with the predicted morbidity and mortality rates.

We concluded that POSSUM scoring is effective in predicting the risk of morbidity & mortality in patients undergoing laparotomy for perforative peritonitis.

Keywords: Perforative peritonitis. POSSUM, evaluation