Muchdor, - (2003) Kegunaan Skor Possum Pada Pasien Peritonitis Generalisata Untuk Membantu Audit Terapi Bedah. Thesis thesis, UNIVERSITAS AIRLANGGA.

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Abstract

BACKGROUND: Generalized peritonitis is a complex case with high morbidity and mortality rates. Surgical audit is an important system used to assess quality of surgical care determined by indicators i.e. morbidity and mortality rates. Quality of surgical care is not only determined by the surgeon's capability but furthermore by the patient's physiological state and intraoperative condition. It is well recognized that there is a need for an accurate system for predicting morbidity and mortality against which outcome can be compared. It has been considered that POSSUM score which amalgamates patient's physiological score with the patient's operative severity score, predicting both morbidity and mortality risks, proves to be a potentially useful system. OBJECTIVE:To learn the benefit of POSSUM Score in predicting morbidity and mortality of patients with generalized peritonitis who underwent operation. METHODS: Throughout June to September 2003, 28 patients assessed with generalized peritonitis, were entered into this study. All cases were evaluated utilizing the POSSUM Score, using independent scoring sheets. Postoperative complications and deaths within 30 days were recorded. RESULTS: The overall observed morbidity rate was 42,9% and the predicted rate was 82,79%. Comparison of observed and predicted morbidity rates, i.e. the O:E ratio was 0,52 or less than 1. The overall observed mortality rate was 28,6% and the • predicted rate was 32,55% and the O:E ratio was 0,88 or less than 1. The result from the statistical analysis method, using X2 test, evaluating morbidity, showed that up to the cut off point > 95% on POSSUM Score for morbidity, there was no significat correlation. In predicting mortality, POSSUM Score was significant at the cut off point of 40%, with 100% sensitivity and 85% specificity with p= 0,0001. CONCLUSION:POSSUM Score accurately predicted mortality in patients with generalized peritonitis who underwent operation, but in predicting morbidity it resulted in inaccuracy or overprediction

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