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POSSUM Score Components

Doctors use POSSUM to assess a patient's condition. Surgeons use the POSSUM scoring system to determine a patient's surgical risk. POSSUM is short for Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity. Scientists developed this system in 1991, according to RiskPrediction.org.uk, factoring the patient's condition with operative parameters to assign a numerical value to a patient's surgical risk. Doctors now use POSSUM to assess patient risk for death in many surgical practices, including orthopedics and vascular procedures.

  1. Components

    • A POSSUM score has two main components: physiologic severity and operative severity. Physiologic severity encompasses the patient's overall condition, including his age, vital signs, blood chemistry, mental status and the condition of his heart. Operative severity accounts for the seriousness of the procedure, how well the operation went and if the surgeon discovered cancer. Doctors calculate these two components to give the medical staff an indication of the patient's post-operative prognosis.

    Glasgow Score

    • The medical staff will determine a patient's Glasgow score and then factor this score into POSSUM. A Glasgow score measures a patient's verbal and motor skills, along with the strength of stimulus required for the patient to open his eyes, and reports a number. Société Française d'Anesthésie et de Réanimation provides an interactive Glasgow score tool which states that a patient who opens his eyes and is in full control of his motor skills, yet seems confused or combative, rates a high mark of 14 on a Glasgow scale. A comatose patient who does not open her eyes, does not speak and cannot move scores a three.

    Vital Signs

    • The patient's vital signs contribute to his POSSUM score. The nurse monitors the patient's pulse and blood pressure. He will also monitor the quality of the patient's respiratory system, including trouble breathing or anomalies noted on chest X-ray. Medical staff will evaluate the patient's circulatory system as part of the POSSUM score, noting any ensuring heart problems or resulting from surgery, chronic cardiovascular problems and any medications prescribed to address those issues.

    Laboratory Values

    • Surgeons enter a patient's laboratory values into the POSSUM scoring system. Urea, hemoglobin, white blood cells, potassium and sodium results are particular important. Medical professionals factor information gained from ECG into a patient's POSSUM score.

    Operative Severity

    • Operative severity is classified into minor, moderate, major and major +. Examples of a moderate surgery include appendectomy and mastectomy. Bowel resection and major amputation warrant rating as a major operation. Major + procedures include heart surgery and liver resection.

    Operative Events

    • A surgeon will factor in operative events like the amount of blood lost during surgery, the number of procedures she performed and whether she performed the surgery as an emergency or an elective. She will also note whether she found cancer and if any blood, stool, pus or body fluids leaked into the patient's peritoneal area.

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