PHYSIOLOGICAL SCORE | |||
---|---|---|---|
Age | |||
<60 | 61-70 | >71 | |
Cardiovascular | |||
Normal | Diuretic, digoxin, antianginal antiHTN | Peripheral oedema, warfarin, borderline c'myopathy | raised JVP, c'megaly |
Respiratory | |||
No dyspnoea | Dyspnoea on exertion, mild COPD | Limiting dyspnoea (1 flight), mod COPD | Dyspnoea at rest, fibrosis or consolidation |
ECG | |||
Normal | AF, rate 60-90 | Any other abnormal rhythm, >4/min extopics, Q waves, ST/T changes | |
Systolic blood pressure | |||
110 - 130 | 100 - 109 or 131 - 170 |
>170 or 90-99 |
<99 |
Pulse rate | |||
50 - 80 | 40 - 49 or 81 - 100 |
101 - 120 | <40 or >120 |
Haemoglobin | |||
130 - 160 | 115 - 129 or 161 - 170 |
100 - 114 or 171 - 180 |
<100 or >180 |
WBC | |||
4 - 10 | 10.1 - 20 or 3.1 - 4 |
>20 or <3 | |
Urea | |||
<7.6 | 7.6 - 10 | 10.1 - 15 | >15 |
Sodium | |||
>135 | 131 - 135 | 126 - 130 | <126 |
Potassium | |||
3.5 - 5 | 3.2 - 3.4 or 5.1 - 5.2 |
2.9 - 3.1 or 5.4 - 5.9 |
<2.9 or gt;5.9 |
GCS | |||
15 | 12 - 14 | 9 - 11 | <9 |
OPERATIVE SCORE | |||
Operation type | |||
Minor operation | Moderate operation | Major operation | Complex major operation |
Number of procedures | |||
One | Two | >2 | |
Operative blood loss (ml) | |||
<100 | 101-500 | 501-999 | >1000 |
Peritoneal Contamination | |||
No soiling | Minor soiling | Local pus | Free bowel content, pus or blood |
Malignancy Status | |||
Not malignant | Primary malignancy only | Malignancy + nodal mets | Malignancy + distant mets |
CEPOD | |||
Elective | Urgent emergency | Emergency (within 2 hours) |
POSSUM
Home AboutAbout Possum
- There is some variation in constants used. I have used:
- Possum morbidity logit R = ln[R/(1-R)]=-5.92 + (0.16 x physiological) + (0.19 x operative)
- Possum mortality logit R = ln[R/(1-R)]=-7.04 + (0.13 x physiological) + (0.16 x operative)
- P-Possum mortality logit R = ln[R/(1-R)]=-9.065+ (0.1692 x physiological) + (0.155 x operative)
- POSSUM (Copeland 1991) possibly over-predicts death in especially in low-risk patients (Whiteley et al 1998).
- P-Possum (D.Prytherch) was supposed to be better, but subsequently found to be equivalent. It still over-predicts death.