David Lagoro Kitara, Ignatius Kakande, Didas B. Mugisa
Patients’ care is the responsibility of individual surgeon but outcomes often depend on large multidisciplinary team and all of whom may affect morbidity and mortality. Adequate knowledge about a patient for operation and those at high risk of dying contributes significantly to the quality of care and cost reduction in surgery. Physiological Operative Severity Score for the Enumeration of Morbidity and Mortality (POSSUM) was used to find out the determinants of mortality following Laparotomy in MNRH. A cohort study was conducted using 76 consecutively recruited patients who underwent emergency and elective laparotomy. POSSUM scoring system was used and patients followed-up to the 30th post-operative day. Day-care surgeries, death on table before induction of anesthesia, and patients below 13 years were excluded. Ethical approval was obtained from research and ethics committee of Makerere University medical school. The determinants of mortality were: Physiological score (PS) (t=2.228, p=0.029; χ 2 =15.862, p=0.003); Diabetes Mellitus (t=3.331, p=0.001); Operative Score (OS) (t=3.280, p=0.002; χ 2 = 14.605, p=0.012); Occupation (Civil service) (t=2.720, p=0.008) and Hospital stay (t= -2.894, p=0.005). POSSUM successfully assessed the determinants of mortality of laparotomy in Mulago National Referral Hospital (MNRH) in a 30 day cohort.
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