KMID : 0371320090770060391
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Journal of the Korean Surgical Society 2009 Volume.77 No. 6 p.391 ~ p.398
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Validation of POSSUM-physiological Score as Predictors of Post-operative Morbidity and Mortality after Emergency Operation for Peptic Ulcer Complications
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Kim Hong-Beom
Ahn Hye-Seong Kwon Jun-Sik Jung In-Mok Ahn Young-Joon Heo Seung-Chul Hwang Ki-Tae Chung Jung-Kee
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Abstract
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Purpose: The POSSUM (Physiological and Operative Severity Score for Enumeration of Mortality and Morbidity) score was developed to predict post-operative mortality and morbidity rates. The aim of this study was to validate the POSSUM physiologic score (POSSUM-P) in emergent operations for peptic ulcer complications.
Methods: We retrospectively collected data on patients who underwent emergent operation for peptic ulcer complications at Boramae Hospital between January 2003 and April 2009. The data included patients¡¯ characteristics (underlying disease, medication, duration of symptoms), operative characteristics (operation method, morbidity, and mortality) and the items for the POSSUM-P (basic information (age, sex, etc.), circulatory and respiratory signs, electrocardiogram, blood pressure, hemoglobin, white blood cell count, potassium level, sodium level, urea level and Glasgow coma scale). The POSSUM-P was calculated and compared according to the morbidity and mortality.
Results: One hundred and twelve patients were included. As for operation methods, primary repair (48.2%) was most common, followed by truncal vagotomy with pyloroplasty (27.7%). Thirty-seven patients had morbidities including wound infections (20), pneumonias (14), fluid collections (9), and so on. Eight patients died due to sepsis or pulmonary edema. The means of POSSUM-P were significantly different between patients with and without mortality (37.8 vs. 19.2, P£¼0.001) and between patients with and without morbidity (26.7 vs. 17.3, P£¼0.001). Those were different between patients with and without postoperative pneumonia and wound infection (P=0.002 and P=0.029, respectively).
Conclusion: The POSSUM physiologic score could help to predict the mortality or morbidity after emergency operation for complications of peptic ulcer disease, especially postoperative pneumonia or wound infection.
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KEYWORD
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POSSUM, Mortality, Morbidity, Peptic ulcer complications
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