Table 1. Parameters to calculate POSSUM score.
POSSUM, physiological and operative severity score for the enumeration of mortality and morbidity; JVP, jugular venous pressure.
| Parameters | Physiological score | |||
| 1 | 2 | 4 | 8 | |
| Age (in years) | ≤ 60 | 61-70 | ≥71 | |
| Cardiac signs | No failure | Diuretic, digoxin, anti-anginal, or antihypertensive therapy | Peripheral edema, warfarin therapy, borderline cardiomegaly | Raised JVP, cardiomegaly |
| Respiratory signs | No dyspnea | Dyspnea on exertion, mild COPD | Limiting dyspnea (one flight), moderate/COPD | Dyspnea at rest (rate ≥30/min), fibrosis, or consolidation |
| Blood pressure (systolic in mmHg) | 110- 130 | 131-170; 100-109 | ≥171; 90-99 | ≤89 |
| Pulse (beats/min) | 50-80 | 81-100; 40-49 | 101-120 | ≥120; ≤39 |
| Glasgow coma scale | 15 | 12-14 | 9-11 | ≤8 |
| Hemoglobin | 13-16 | 11.5-12.9; 16.1-17.0 | 10.0-11.4; 17.1-18.0 | ≤9.9; ≥18.1 |
| White cell count (× 1012/L) | 4-10 | 10.1-20.0; 3.1-4.0 | ≥20.1; ≤3.0 | |
| Urea (mg/dL) | ≤40 | 41-55 | 55-80 | ≥80 |
| Sodium (mmol/L) | ≥136 | 131-135 | 126-130 | ≤125 |
| Potassium (mmol/L) | 3.5-5.0 | 3.2-3.4; 5.1-5.3 | 2.9-3.1; 5.4-5.9 | ≥6.0 |
| ECG | Normal | Atrial fibrillation | Any abnormal rhythm or ≥5 ectopics/min, Q waves or ST/T wave changes | |
| Operative severity score | ||||
| 1 | 2 | 4 | 8 | |
| Operative severity | Minor | Moderate | Major | Major+ |
| Multiple procedures | 1 | 2 | >2 | |
| Total blood loss (mL) | ≤100 | 101-500 | 501-999 | ≥1000 |
| Peritoneal soiling | None | Minor (serous fluid) | Local pus | Free bowel content (pus or blood) |
| Presence of malignancy | None | Primary only | Nodal metastases | Distant metastases |
| Mode of surgery | Emergency resuscitation or >2 h possible operation within 24 hours after admission | Emergency (immediate surgery <2 h needed) | ||