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