PP 107. PPOSSUM for Optimising Perioperative Care in Emergency General Surgery
M. Junejo, S. Hafiz, A Hoyle, S. Kurrimboccus
16:42 - 16:48h
at Margrit Room
Categories: Emergency Surgery, Poster Session
Session: Poster II (P3) - Emergency / Thoracic Surgery
Background
Emergency General Surgery (EGS) in the UK accounts for 80% to 90% of mortality from surgical procedures. The POSSUM (Physiological and Operative Severity for the enUmeration of Mortality and Morbidity) score is a useful pre-operative scoring system to predict perioperative mortality and morbidity to inform surgical management and level of peri and postoperative care. As part of quality improvement and auditing of outcomes, it is calculated for all EGS procedures in our hospital. Patients with prerdicted mortalty of >5% are regarded as 'high-risk' and should be considered for critcal care support.
Material and Methods
A retrospective audit of the use of preoperative POSSUM scoring at a tertiary centre was carried out for EGS procedures. Data was collected during a five-week study period to assess utilisation of the score in planning surgical management and perioperative care.
Result
A total of 31 operations consisted of incision and drainages of abscesses, appendectomies, laparotomies, hernia repairs and cholecystectomies with the mean age of 38 years. 3 procedures constituted 'high-risk' surgery but only one patient received postopertaive critical care support.
Conclusion
The PPOSSUM score was calculated for theatre audit but documented in the notes in only 2% of the cases. It remains unclear weather the information provided was used clinically to inform risk of surgery and the level of perioperative care. Only one patient recieved critical care support as per guidelines. It is important that its utility is realised beyond providing audit statistics, to inform
patient and physican when negotiating perioperative care inpatients undergoing EGS.
