Table 3

Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) (Copeland et al)44

POSSUM physiological variables
Score1248
Age, years<6061–70>71
  • Cardiac signs

  • CXR

  • Normal

  • Normal

  • Cardiac drugs or Steroids

  • Oedema:

  • Warfarin

  • Borderline cardiomegaly

  • JVP

  • Cardiomegaly

  • Respiratory signs

  • CXR

  • Normal

  • Normal

  • SOB exertion

  • Mild COAD

  • SOB stairs

  • Moderate COAD

  • SOB rest

  • Any other change

Systolic BP, mm Hg110–130
  • 131–170

  • 100–109

  • >171

  • 90–99

<80
Pulse beats/min50–80
  • 81–100

  • 40–49

  • 101–120

  • >121

  • <39

Coma score1512–148–11<8
Urea nitrogen (mmol/l)<7.57.6–1010.1–15>15.1
Sodium (mEq/l)>136131–135126–130<125
Potassium (mEq/l)3.5–5
  • 3.2–3.4

  • 5.1–5.3

  • 2.9–3.1

  • 5.4–5.9

  • <2.8

  • >6

Haemoglobin (g/dl)13–15
  • 11.5–12.9

  • 16.1–17

  • 10–11.4

  • 17.1–18

  • <9.9

  • >18.1

WCC (×1012/l)4–10
  • 10.1–20

  • 3.1–3.9

  • >20.1

  • <3

ECGNormalAF (60–90)Any other change
POSSUM surgical variables
Score1248
Operative magnitudeMinorIntermediateMajorMajor+
No. of operations within 30 days12>2
Blood loss per operation (ml)<100101–500501–999>1000
Peritoneal contaminationNoSerousLocal pusFree bowel content, pus or blood
Presence of malignancyNoPrimary cancer onlyNode metastasesDistant metastases
Timing of operationElectiveEmergency, resuscitation possible, operation <24 hEmergency, immediate operation <2 h
  • AF, atrial fibrillation; COAD, chronic obstructive airway disease; CXR, chest x ray; BP, blood pressure; ECG, electrocardiogram; JVP, jugular venous pressure; SOB, shortness of breath; WCC, white cell count.