Recently with the rapid development of diagnosis and curative techniques in surgical department, coverage of operation increased and a lot of difficult operations and those in bad conditions became feasible. And also a variety of surgical methods from micro operation to extended operation have been shown.
Therefore, the world has the individualization in the choice of operating methods according to the preoperative vital index of the patient, complication with the diseases, concomitant diseases and burden of operation to be applied.
There have been a lot of achievements in the study to expect the post operative fatality under the condition of the patient according to the kinds of the operation and to choose the rational method of operation.
At present, POSSUM (Physiological and Operative Severity Score for enumeration Mortality and Morbidity) is widely used in the world which is suggested by a scientist in UK.
In general this program is estimated to work well, but some countries have revised it in accordance with the medical practice, because of the differences in the medical practice of their countries.
So, we found the main factors in the condition information of the patient before operation which has an effect on death after some urgent operations, got the model formulas for quantitative expectation of death possibility after acute abdominal operation and verified the correctness.
We analyzed the condition information of the patients to have an effect on 5 748 patients (the postoperative dead 107) after some urgent abdominal operations (appendectomy, operation of gastric and duodenal ulcer, ileus, cholecystic and biliary duct, pancreatitis), in which mortality from preoperative complications, preoperative concomitant diseases and old age were 59.8%, 19.6%, 9.3% respectatively, and this showed that mortality from condition of the patient before operation(88.8%) was higher than mortality from post operative complications(11.2%). The patients were operated in Pyongyang Medical College Hospital,
Mortality from old age was the highest, 15.4% in the patient operated for appendicitis and the following was respectatively 12.0%, 11.1%, 4.3% in thepatients operated for appendectomy, operation of gastric and duodenal ulcer,ileus, cholecystic and biliary duct, pancreatitis. And there was 0.0% in the patients operated for the appendicitis.
On the basis of these information, we obtained the expectation model formula with Quqntification One Anlyasis, for quantitative expectation of death possibility after urgent abdominal operations, verified the correctness and introduced into the medical practice with the program.
When we applied the post operative dead possibility expecting regression formula presumed before operation, the operation can be possible under 70% of expectancy, but over 70%, the measure should be taken in order to decrease the dead possibility.
That is, the method should be chosen to decrease the death possibility; when the eradicative operation is impossible, it is necessary to save the patient from the death and if he gets a little better, it will be good to operate him for the permanent cure.
