WJCC World Journal of Clinical Cases Submit a Manuscript: https://www.f6publishing.com World J Clin Cases 2019 August 26; 7(16): 2227-2237 DOI: 10.12998/wjcc.v7.i16.2227 ISSN 2307-8960 (online) ORIGINAL ARTICLE Clinical Trials Study Comparative analysis of APACHE-II and P-POSSUM scoring systems in predicting postoperative mortality in patients undergoing emergency laparotomy Deb Sanjay Nag, Ankur Dembla, Pratap Rudra Mahanty, Shashi Kant, Abhishek Chatterjee, Devi Prasad Samaddar, Parul Chugh ORCID number: Deb Sanjay Nag (0000-0003-2200-9324); Ankur Dembla (0000-0001-7257-0326); Pratap Rudra Mahanty (0000-0001-8063-8538); Shashi Kant (0000-0002-2718-479X); Abhishek Chatterjee (0000-0002-9570-2747); Devi Prasad Samaddar (0000-0001-7759-970X); Parul Chugh (0000-0003-4898-7652). Author contributions: Nag DS, Dembla A, Mahanty PR, and Chatterjee A planned and conducted of the study, scored the patients, and prepared and edited the manuscript; Kant S and Samaddar DP prepared manuscript, reviewed the literature, and analyzed the findings; Chugh P was involved in the study as a biomedical statistician and guided the plan of the study, determined appropriate sample size, and performed statistical analysis and interpretation. Institutional review board statement: The observational study was approved by the Hospital Ethics Committee, Tata Main Hospital. Clinical trial registration statement: The registration identification No. NCT02471612. Conflict-of-interest statement: The authors declare that they have no conflicts of interest. Open-Access: This article is an open-access article which was Deb Sanjay Nag, Pratap Rudra Mahanty, Shashi Kant, Abhishek Chatterjee, Devi Prasad Samaddar, Department of Anaesthesiology and Critical Care, Tata Main Hospital, Jamshedpur 831001, India Ankur Dembla, Department of Anaesthesiology and Critical Care, Darya Ram Hospital, Sonipat 131001, India Parul Chugh, Department of Biomedical Statistics, Sir Ganga Ram Hospital, New Delhi 110060, India Corresponding author: Deb Sanjay Nag, MBBS, MD (Gold Medalist), Senior Consultant, Department of Anaesthesiology, Tata Main Hospital, C Road West, Northern Town, Jamshedpur 831001, India. ds.nag@tatasteel.com Telephone: +91-943-1166582 Fax: +91-657-2224559 Abstract BACKGROUND Laparotomy remains one of the commonest emergency surgical procedures. Early prognostic evaluation would aid in selecting the high-risk patients for an aggressive treatment. Awareness about risks could potentially contribute to the quality of perioperative care and optimum utilization of resources. Portsmouth modification of Physiological and operative severity for the enumeration of mortality and morbidity (P-POSSUM) and the acute physiology and chronic health evaluation II (APACHE-II) have been the most widely used scoring systems for emergency laparotomies. It is always better to have a single scoring system to predict outcomes and audit healthcare organizations. AIM To compare the ability of APACHE-II and P-POSSUM to predict postoperative morbidity and mortality in patients undergoing emergency laparotomy. METHODS All patients undergoing emergency laparotomy at the Tata Main Hospital, Jamshedpur between December 2013 and November 2014 were included in the study. In this observational study, P-POSSUM and APACHE-II scoring were done, and the outcome analysis evaluated with mortality being the primary WJCC https://www.wjgnet.com August 26, 2019 Volume 7 Issue 16 2227