POSSUM: a scoring system for surgical audit

Br J Surg. 1991 Mar;78(3):355-60. doi: 10.1002/bjs.1800780327.


POSSUM, a Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity, is described. This system has been devised from both a retrospective and prospective analysis and the present paper attempts to validate it prospectively. Logistic regression analysis yielded statistically significant equations for both mortality and morbidity (P less than 0.001). When displayed graphically zones of increasing morbidity and mortality rates could be defined which could be of value in surgical audit. The scoring system produced assessments for morbidity and mortality rates which did not significantly differ from observed rates.

MeSH terms

  • Aged
  • England / epidemiology
  • Hospitals / standards*
  • Humans
  • Medical Audit / methods*
  • Middle Aged
  • Outcome and Process Assessment, Health Care / methods*
  • Postoperative Complications / epidemiology
  • Prospective Studies
  • Regression Analysis
  • Reproducibility of Results
  • Risk
  • Severity of Illness Index*
  • Surgical Procedures, Operative / adverse effects
  • Surgical Procedures, Operative / mortality*