CR-POSSUM — Colorectal POSSUM
Colorectal-specific recalibration of POSSUM (Tekkis 2004) predicting 30-day mortality after colorectal surgery. Sums physiology + operative severity weighted variables. Use the band closest to your calculated value.
Score interpretation
→ Standard elective pathway: ERAS protocol, prehabilitation, day-case if appropriate. Standard ward post-op.
→ Pre-op optimisation: anaemia (IV iron), nutritional status (ONS), cardiopulmonary fitness (CPET), HDU/ITU bed booked. Senior surgeon and anaesthetist led; consider laparoscopic approach to reduce morbidity.
→ MDT discussion. Pre-op CPET, echo, anaesthetic high-risk clinic. ITU bed essential. Detailed informed consent including alternatives (palliative stenting, defunctioning stoma). Consider Hartmann's over anastomosis if perforated.
Interpretation bands for the CR-POSSUM. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- POSSUM Score for Surgical Morbidity and Mortality · Perioperative Risk
- SORT (Surgical Outcome Risk Tool) · Perioperative Risk
- Revised Cardiac Risk Index (RCRI / Lee Index) · Perioperative Risk
- ASA Physical Status Classification · Perioperative Risk
- Gupta Perioperative Risk for MI or Cardiac Arrest (MICA) · Perioperative Risk
- Cardiovascular Risk in Orthotopic Liver Transplantation (CAR-OLT) Score · Perioperative Risk
- Ephedrine Hydrochloride 0.5% Nasal Drops · Nasal decongestant — sympathomimetic (perioperative / ENT use)
- Palivizumab · RSV Prophylaxis — Monthly Monoclonal Antibody (High-Risk Infants)
- Cefazolin (Perioperative Burns) · First-Generation Cephalosporin
- Ziprasidone · Atypical Antipsychotic — D2/5-HT2A Antagonist (Low Metabolic Risk)
- Atorvastatin (CKD Cardiovascular Risk) · Cardiovascular Risk in CKD
- Ondansetron (Perioperative) · 5-HT3 Receptor Antagonist (Antiemetic)
- Major Trauma — Primary Survey (ATLS) · ATLS 10th Edition; JRCALC; NICE NG39
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Burns — TBSA Estimation & Fluid Resuscitation · British Burn Association; EMSB; RCEM 2024
- Lower Gastrointestinal Bleed · NICE; BSG; ACPGBI — Commissioning Guide
- Acute Pancreatitis · NICE; IAP/APA; ACPGBI — CG104
- Hypertrophic Pyloric Stenosis · BAPS / RCPCH
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.