Predictive value of POSSUM score in surgery of acute abdomen in cirrhotic patients

Abstract Introduction: As liver cirrhosis has an increasing incidence in the general population and the life expectancy for these patients has increased, surgery procedures practiced for acute abdomen in such category of patients are more frequent. Aim: To evaluate the predictive value of POSSUM score in cirrhotic patients undergoing abdominal surgery in emergency cases. Material and method: A prospective study based on 115 consecutive patients with liver cirrhosis hospitalized and operated in the first 24 hours from admission for acute abdomen. The patients’ stratification was done by using Child Pugh score for liver cirrhosis. POSSUM score was calculated for each patient and postoperative outcomes were compared with prediction based on this score. Statistical data analysis was made by using the chi-square test and a p value of less than 0,05 was considered to be statistically significant. Results: There were 33 patients in stage Child A of cirrhosis, 54 in stage Child B and 28 in stage Child C. For Child A group, the POSSUM score had a satisfactory prediction in terms of morbidity and mortality. In advanced stages of liver cirrhosis, Child B and C, mortality had high rate and the observed outcomes were outside the area of POSSUM score prediction. Conclusions: POSSUM score offers a satisfactory prediction for morbidity and mortality in emergency abdominal surgery for patients in compensated stages of liver cirrhosis. In advanced stages of cirrhosis high levels of mortality cannot be predicted by using POSSUM score.