The Postoperative Complications Prediction in Mulago Hospital using POSSUM Scoring System

Abstract

Introduction: Prediction of complications is an essential part of risk management in surgery. Knowing which patient to operate and those at high risk of developing complications contributes significantly to the quality of surgical care and cost reduction. The postoperative complications of patients who underwent Laparotomy in Mulago Hospital were studied using POSSUM scoring system. The main objective of this study was to determine the postoperative complications of Laparotomy in Mulago Hospital, between September 2003 and February 2004.

Methods: Consecutive patients, who underwent Laparotomy in Mulago, were studied using POSSUM system for development of complications. For each patient operated, they were followed up in wards until discharge. When the postoperative complications were reported, they were reexamined by the surgeons, treated and followed up for 30 days postoperatively. Phone contacts were used for the follow up. Surgical reviews were conducted once a week in Mulago Hospital and the data obtained recorded in the data sheet for the patients.

Results: Seventy-six patients were studied. The observed post operative complications were as follows: Respiratory tract infection (28.2%), wound haemmorrhage (18.2%), anaemia (15.5%), hypotension (14.1%), UTI (2.2%), Anastomotic leak (1.4%), Wound sepsis (9.9%), wound dehiscence (4.2%), Thromboembolism (1.4%). The postoperative nursing care significantly determined the outcomes.

Conclusion: Postoperative complications can be predicted in the modern management of surgery especially while using a scoring system.