Home POSSUM Score POSSUM score

POSSUM score

229
0
Criteria Point Value
Age (Years)
<60 1
61-70 2
>71 4
Cardiac Signs
No Failure 1
Diuretic, Digoxin, antianginal or antihypertensive therapy 2
Peripheral edema, anticoagulant therapy 4
Raised JVP 8
Chest X-Ray
Normal 1
Borderline cardiomegaly 4
Cardiomegaly 8
Respiratory History
No Dyspnoea 1
Dyspnoea on exertion 2
Limiting dyspnea (one flight of stairs) 4
Dyspnoea at Rest (rate > 30/min) 8
Chest X-Ray
Normal 1
Mild COAD 2
Moderate COAD 4
Fibrosis or Consolidation 8
Blood pressure (systolic)(mmHg)
110-130 1
131-170 or 100-109 2
> 171 or 90-99 4
< 89 8
Pulse (beats/min)
50-80 1
81-100 or 40-49 2
101-120 4
> 121 or < 39 8
Glasgow coma Scale
15 1
12-14 2
9-11 4
<8 8
Hemoglobin(g/dl)
13-16 1
11.5-12.9 or 16.1-17.0 2
10.0-11.4 or 17.1-18.0 4
≥18.1 8
White cell count (×1012/l)
4-10 1
10.1-20 or 3.1-4 2
≥20.1 or ≤3 4
Blood urea(mmol/l)
≤7.5 1
7.6-10 2
10.1-15 4
≥15.1 8
Sodium (mmol/l)
≥136 1
131-135 2
126-130 4
≤125 8
Potassium (mmol/l)
3.5-5 1
3.2-3.4 or 5.1-5.3 2
2.9-3.1 or 5.4-5.9 4
≤2.8 or ≥6 8
ECG
Normal 1
Atrial fibrillation (rate 60-90) 4
Any other abnormal rhythm or ≥ 5 ectopics/min Q waves or ST/T wave changes 8
Operative severity
Minor 1
Moderate 2
Major 4
Major Plus 4
Major Plus 8
Multiple procedures
0 1
1 2
2 4
>2 4
Total blood loss (ml)
<100 1
101-500 2
501-999 4
>1000 8
Peritoneal soiling
None 1
Minor (serous fluid) 2
Local pus 4
Free bowel content, pus or blood 8
Presence of malignancy
None 1
Primary only 2
Nodal metastases 4
Distant metastases 8
Mode of surgery
Elective 1
Emergency 2
resuscitation of >2 h possible, 4
Operation < 24 h after admission 8

 

POSSUM formula:

Ln R/1-R = -7.04 + (0.13 x physiological score) + (0.16 x operative severity score)

 

P-POSSUM formula:

Ln R/1-R = -9.065 + (0.1692 x physiological score) + (0.1550 x operative severity score)

 

where R = predicted risk of mortality