Table 1 Physiologic and Operative Severity Scoring for the enUmeration of Mortality and morbidity (POSSUM) score
Physiological score | ||||
|---|---|---|---|---|
Score → | 1 | 2 | 4 | 8 |
Age | ≤ 60 | 61–70 | ≥ 71 |  |
Cardiac signs Chest radiograph | No failure Normal | Cardiac drugs or steroids | Peripheral edema, anticoag treatment Borderline cardiomegaly, | ↑JVP, Cardiomegaly |
Respiratory history | No dyspnoea | Dyspnea on exertion | Limiting dyspnea (One flight) | Dyspnoea at rest (>30/mt) |
Chest radiograph | Normal | Mild COAD | Moderate COAD | Any other change |
B.P(Systolic) mm Hg | 110–130 | 131–170 100–109 | ≥ 171 90–99 | ≤ 89 |
Pulse | 50–80 | 81–100 40–49 | 101–120 | ≥ 121 ≤ 39 |
GCS | 15 | 12–14 | 9–11 | ≤ 8 |
Hb | 13–16 | 11.5–12.9 16.1–17 | 10–11.4 17.1–18 | ≤ 9.9 ≥ 18.1 |
WBC(×103/cu mm) | 4–10 | 10.1–20 3.1–4.0 | ≥ 20.1 ≤ 3.0 |  |
Bl. Urea | ≤ 7.5 | 7.6–10 | 10.1–15.0 | ≥ 15.1 |
Na+ | ≥ 136 | 131–135 | 126–130 | ≤ 125 |
K+ | 3.5–5.0 | 3.2–3.4 5.1–5.3 | 2.9–3.1 5.4–5.9 | ≤ 2.8 ≥ 6.0 |
ECG | Normal |  | Atrial fibrillation (rate 60–90) | Any other abnormal rhythm or ≥ 5 ectopics/min, Q waves or ST/T wave changes |
Operative Severity Score | ||||
Score → | 1 | 2 | 4 | 8 |
Operative severity | Minor | Moderate | Major | Major+ |
Multiple procedure | 1 | Â | 2 | >2 |
Total blood Loss | ≤ 100 | 101 – 500 | 501 – 999 | ≥ 1000 |
Peritoneal soiling | None | Minor Serous fluid | Local Pus | Free bowel contents, pus or blood |
Malignancy | None | Primary only | Nodal Mets | Distant Mets |
Mode of surgery | Elective | Â | Emergency resusc of > 2 hrs possible, Op <24 hrs after admission | Emergency surgery, 2 hrs of resusc not possible |