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소화성 궤양 합병증으로 응급수술을 시행한 환자에서 수술 후 합병증 예측인자로서 POSSUM-physiological Score의 유용성
Validation of POSSUM-physiological Score as Predictors of Post-operative Morbidity and Mortality after Emergency Operation for Peptic Ulcer Complications

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Authors
김홍범; 안혜성; 김준식; 정인목; 안영준; 허승철; 황기태; 정중기
Issue Date
2009-12
Publisher
KOREAN SURGICAL SOCIETY
Citation
JOURNAL OF THE KOREAN SURGICAL SOCIETY; Vol.77 6; 391-398
Keywords
POSSUMMortalityMorbidityPeptic ulcer complications수술 후 사망수술 후 합병증소화성 궤양 합병증
Abstract
Purpose: The POSSUM (Physiological and Operative Severity Score for Enumeration of Mortality and Morbidity) score was developed to predict post-operative mortality and morbidity rates. The aim of this study was to validate the POSSUM physiologic score (POSSUM-P) in emergent operations for peptic ulcer complications. Methods: We retrospectively collected data on patients who underwent emergent operation for peptic ulcer complications at Boramae Hospital between January 2003 and April 2009. The data included patients` characteristics (underlying disease, medication, duration of symptoms), operative characteristics (operation method, Morbidity, and mortality) and the items for the POSSUM-P (basic information (age, sex, etc.), circulatory and respiratory signs, electrocardiogram, blood pressure, hemoglobin, white blood cell count, potassium level, sodium level, urea level and Glasgow coma scale). The POSSUM-P was calculated and compared according to the morbidity and mortality. Results: One hundred and twelve patients were included. As for operation methods, primary repair (48.2%) was most common, followed by truncal vagotomy with pyloroplasty (27.7%). Thirty-seven patients had morbidities including wound infections (20), pneumonias (14), fluid collections (9), and so on. Eight patients died due to sepsis or pulmonary edema. The means of POSSUM-P were significantly different between patients with and without mortality (37.8 vs. 19.2, P < 0.001) and between patients with and without morbidity (26.7 vs. 17.3, P < 0.001). Those were different between patients with and without postoperative postoperative pneumonia and wound infection (P=0.002 and P=0.029, respectively). Conclusion: The POSSUM physiologic score Could help to predict the mortality or morbidity after emergency operation for complications of peptic ulcer disease, especially postoperative pneumonia or wound infection. (J Korean Surg Soc 2009;77:391-398)
ISSN
2233-7903
Language
Korean
URI
http://hdl.handle.net/10371/77928
DOI
https://doi.org/10.4174/jkss.2009.77.6.391
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College of Medicine/School of Medicine (의과대학/대학원)Surgery (외과학전공)Journal Papers (저널논문_외과학전공)
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