Bullagan Akarsh, Jain Atul, Agarwal Suhas, Saxena Vaishali, Karim Tanweer, Chakravarti Sumit
Department of Surgery, ESIC Model Hospital and Postgraduate, Institute of Medical Sciences and Research, New Delhi, India.
Oman Med J. 2025 Jan 31;40(1):e711. doi: 10.5001/omj.2025.43. eCollection 2025 Jan.
The aim of the study was to assess morbidity and mortality outcomes using the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) and Portsmouth POSSUM (P-POSSUM) scores in patients undergoing emergency gastrointestinal surgeries, and to compare the capabilities of POSSUM and P-POSSUM models in predicting mortality and morbidity.
In this prospective observational study, participants were selected from patients undergoing emergency gastrointestinal surgery at our hospital. The physiological component of POSSUM and P-POSSUM scores was calculated preoperatively, while the operative component was determined intraoperatively.
A total of 45 patients were included in the study, with a mean age of 37.9 ± 15.7 years. The male-female ratio was 1.5:1.0. Intestinal perforation was the most common diagnosis (15; 33.3%) that necessitated exploratory laparotomy. The cutoff of POSSUM morbidity score of 87.5% had a sensitivity of 83.3% and a specificity of 92.6%, while the cutoff P-POSSUM morbidity score of 88.6% yielded a sensitivity of 88.9% and a specificity of 96.3%. Regarding mortality prediction, the cutoff POSSUM mortality score of 56.7% had a sensitivity of 87.5% and a specificity of 94.6%, while a P-POSSUM mortality cutoff score of 22.7% had a sensitivity of 100% and a specificity of 81.1%.
Both POSSUM and P-POSSUM scores demonstrated significant sensitivity and specificity in predicting morbidity and mortality in patients undergoing emergency gastrointestinal surgeries. They can be effectively utilized for risk assessment in clinical practice.
本研究旨在使用生理和手术严重程度评分系统（POSSUM）及朴茨茅斯POSSUM（P-POSSUM）评分，评估接受急诊胃肠道手术患者的发病率和死亡率结局，并比较POSSUM和P-POSSUM模型预测死亡率和发病率的能力。
在这项前瞻性观察性研究中，参与者选自我院接受急诊胃肠道手术的患者。术前计算POSSUM和P-POSSUM评分的生理部分，术中确定手术部分。
本研究共纳入45例患者，平均年龄为37.9±15.7岁。男女比例为1.5:1.0。肠穿孔是最常见的诊断（15例；33.3%），需要进行剖腹探查术。POSSUM发病率评分的临界值为87.5%，敏感性为83.3%，特异性为92.6%；而P-POSSUM发病率评分的临界值为88.6%，敏感性为88.9%，特异性为96.3%。关于死亡率预测，POSSUM死亡率评分的临界值为56.7%，敏感性为87.5%，特异性为94.6%；而P-POSSUM死亡率临界值为22.7%，敏感性为100%，特异性为81.1%。
POSSUM和P-POSSUM评分在预测急诊胃肠道手术患者的发病率和死亡率方面均显示出显著的敏感性和特异性。它们可有效地用于临床实践中的风险评估。
