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About POSSUM scores |
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POSSUM stands for Physiologic and Operative Severity Score for the enUmeration of Mortality and Morbidity. It was developed by Copeland et al in 1991 in a general surgery population and has since been adapted for use in the vascular, colorectal, and oesophagogastric groups, although it has been utilized in other specialties.. It uses 12 physiologic/biochemical variables, and 6 operative variables to give an estimation of mortality risk. Anaesthetists are generally less aware (than surgeons) of POSSUM than other scoring systems e.g. ASA for general risk prediction and APACHE for critically ill patients on ITU. ASA is too simplistic and highly subjective and APACHE too complex for general use. POSSUM lies somewhere between these two systems, closer to APACHE but requires fewer parameters for its calculation. POSSUM can even be used to give an estimate of risk providing those clinicians handling the data understand the implications. P-POSSUM or Portsmouth POSSUM was a modification of the original equation (Whiteley et al 1998) that attempted to counteract the overprediction of mortality in low risk patients. It uses the same variables and may still overpredict mortality in low risk groups but is a better 'fit' than POSSUM. There is a summary at the Royal College of Surgeons (Ed) website here and at www.riskprediction.org.uk
References 1. Copeland GP, Jones D, Walters M 2. Prytherch DR, Whiteley MS, Higgins B, Weaver PC, Prout WG, Powell SJ
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