Table 1 POSSUM Scoring System
From: Risk assessment and decision-making for patients undergoing orthopedic surgery
Score | ||||
|---|---|---|---|---|
1 | 2 | 4 | 8 | |
Physiological scores | ||||
Age (years) | ≤60 | 61–70 | ≥71 | |
Cardiac signs | Normal | Cardiac drugs or steroid | Edema Warfarin | Raised jugular venous pressure |
Resp signs | Normal | SOB exertion | SOB stairs | SOB rest |
Mild COPD | Mod COPD | Other changes | ||
Systolic BP (mmHg) | 110–130 | 131–170 | ≥171 | ≤89 |
100–109 | 90–99 | |||
Pulse (/min) | 50–80 | 81–100 | 101–120 | ≥121 |
40–49 | ≤39 | |||
Glasgow scores | 15 | 12–14 | 9–11 | ≤8 |
Blood urea (mmol/l) | ≤7.5 | 7.6–10 | 10.1–15 | ≥15.1 |
Blood Na+ (mmol/l) | ≥136 | 131–135 | 126–130 | ≤125 |
Blood K+ (mmol/l) | 3.5–5 | 3.2–3.4 | 2.9–3.1 | ≥6 |
5.1–5.3 | 5.4–5.9 | ≤2.8 | ||
Hb (g/100 ml) | 130–160 | 115–129 | 100–114 | ≥181 |
161–170 | 171–180 | ≤99 | ||
White cell count (×109/l) | 4–10 | 10.1–20 | ≥20.1 | |
3.1–3.9 | ≤3 | |||
ECG | Normal | Atrial fibrillation (60–90) | Any other changes | |
Operative severity score | ||||
Magnitude | Minor | Inter | Major | Major+ |
Number of operative variables within 30 days | 1 | 2 | ≥3 | |
Blood loss (ml) | ≤100 | 101–500 | 501–999 | ≥1000 |
Contamination Abdominal cavity infection | None | Incised wound | Minor contamination | Gross contamination |
Presence of malignancy | None | Primary | Node metastases | Distant metastases |
Timing of operation | Elective | Emergency (<24 h) | Emergency (<6 h) | |