anaesthesia-icu

POSSUM Score for Surgical Morbidity and Mortality

Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM). Uses 12 physiological and 6 operative variables to predict 30-day morbidity and mortality. P-POSSUM is modified for mortality prediction.

Age (years)*

Cardiac signs*

Respiratory signs*

Systolic blood pressure (mmHg)*

Pulse rate (bpm)*

Glasgow Coma Score*

Haemoglobin (g/dL)*

WCC (×10³/mm³)*

Urea (mmol/L)*

Sodium (mmol/L)*

Potassium (mmol/L)*

ECG*

Operative severity*

Multiple procedures*

Total blood loss (mL)*

Peritoneal contamination*

Presence of malignancy*

Timing of operation*

Score interpretation

Predicted Mortality < 5 % 0–4.99

Predicted in-hospital mortality below 5 % — RCS 2018: not to be regarded as 'low risk'.

→ Standard perioperative care; reassess if the clinical picture changes.

High Risk (≥ 5 %) 5–25

Predicted mortality ≥ 5 % — a high-risk surgical patient (RCS 2018; NELA standards).

→ Consultant surgeon and consultant anaesthetist present; plan postoperative critical care.

Very High Risk (> 25 %) 25.01–100

Predicted mortality above 25 %.

→ Pre-operative in-person review by consultant surgeon, anaesthetist and critical-care consultant (RCS 2018); shared decision-making.

Interpretation bands for the POSSUM. Apply clinical judgement and local guidance.

References

Copeland GP et al. POSSUM: a scoring system for surgical audit. Br J Surg. 1991;78(3):355–360.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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