Positive Predictive Value Of Possum Scoring In Outcome Prediction In Laparotomies

Abstract

Background: Early prognostic evaluation of laparotomies patients is desirable to select the high-risk patients for a more aggressive treatment. The continuous monitoring and audit of clinical practice is an essential part of making improvements in medical science and enhancing patient care. P-POSSUM remain the most commonly used scoring system in laparotomies for prediction of mortality and morbidity. Material & Methods: 50 Patients undergoing emergency or elective laparotomy were scored according to their physiological pre-op, post-op & intra-operative parameters and findings. And thus, final expected mortality rate and morbidity rate was calculated according to P-POSSUM scoring system. Positive predictable value (PPV) and sensitivity were calculated. Results: In this study, True Positives are 27, False Positives are 12, False Negative is 0 & True Negatives are 11. Sensitivity of the P-POSSUM scoring system is 100%. Positive predictive value is 69.23%. Conclusion: P-POSSUM remain the most commonly used scoring system in laparotomies. POSSUM is subjective scoring system but in actual study morbidity is near or less than expected. It may due to vigorous post-operative management for decreasing morbidity score. It’s a useful tool for clinicians to predict prognosis as well as anticipate development of morbidities. [Surati K Natl J Integr Res Med, 2020; 11(6):28-32]