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East and Central African Journal of Surgery
Association of Surgeons of East Africa and College of Surgeons of East Central and Southern Africa
ISSN: 1024-297X
EISSN: 2073-9990
Vol. 12, No. 2, 2007, pp. 133-142
Bioline Code: js07055
Full paper language: English
Document type: Research Article
Document available free of charge

East and Central African Journal of Surgery, Vol. 12, No. 2, 2007, pp. 133-142

 en POSSUM Scoring System In Patients Undergoing Laparotomy In Mulago Hospital.
Kitara, D.L; Kakande, I. & Mugisa, B.D.

Abstract

Background: Prediction of complications is an essential part of risk management in surgery. Knowing which patient to operate and those at high risk of developing complications contributes significantly to the quality of surgical care and cost reduction in surgery. The physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) was used to score and predict the outcomes of Laparotomy in Mulago Hospital. The main objective of this study was to determine the morbidity and mortality POSSUM scores for patients who underwent Laparotomy in Mulago Hospital, between September 2003 and February 2004.
Methodology: Consecutive patients, who underwent a Laparotomy in the three surgical wards in Mulago Hospital, were scored using POSSUM system. For each patient the predicted risk of mortality and morbidity was calculated from POSSUM equation. Multivariate logistic regression analysis was used to determine the relationships between the predicted and observed morbidity and mortality rates. Postoperative complications and mortality within 30days were described.
Results: Seventy-six patients were studied. The observed and expected mortality and morbidity rates were 14.5%, 2.6% and 35.4%, 0% respectively. Physiological scores, operative scores, co morbid condition such as Diabetes Mellitus significantly determined the outcomes.
Conclusion: POSSUM scoring system can be used to predict the risk of mortality but not morbidity for patients admitted to a surgical ward in Mulago Hospital. Recommendations: The POSSUM scoring system can be used in decision-making process before a Laparotomy is carried out.

 
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