| 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
