POSSUM (operative morbidity & mortality)

POSSUM — Physiological and Operative Severity Score: 12 physiological + 6 operative variables (each graded 1/2/4/8) drive logistic equations for predicted 30-day morbidity and mortality.

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Age
4
Cardiac status
2
Respiratory status
2
Systolic blood pressure
2
Pulse
4
Glasgow Coma Score
1
Hemoglobin
4
White-cell count
2
Urea
4
Sodium
2
The other 8 values
Potassium
1
ECG
4
Operative severity
4
Number of procedures
1
Blood loss
4
Peritoneal soiling
4
Malignancy
1
Urgency
4

Result: POSSUM physiological score 32, operative score 18: predicted 30-day morbidity 93.3%, mortality 50%.

The tool opens with these values already filled in. Replace them with your own.

What the result means

Scores
physiological score 12–88 (12 variables) + operative score 6–48 (6 variables), each graded 1/2/4/8.
Equations
morbidity ln[R/(1−R)] = −5.91 + 0.16·phys + 0.19·op; mortality ln[R/(1−R)] = −7.04 + 0.13·phys + 0.16·op. POSSUM over-predicts mortality at the low end — see P-POSSUM.

What you enter

  • Age (point grade)
  • Cardiac status (point grade)
  • Respiratory status (point grade)
  • Systolic blood pressure (point grade)
  • Pulse (point grade)
  • Glasgow Coma Score (point grade)
  • Hemoglobin (point grade)
  • White-cell count (point grade)
  • Urea (point grade)
  • Sodium (point grade)
The other 8 fields
  • Potassium (point grade)
  • ECG (point grade)
  • Operative severity (point grade)
  • Number of procedures (point grade)
  • Blood loss (point grade)
  • Peritoneal soiling (point grade)
  • Malignancy (point grade)
  • Urgency (point grade)
How this is calculated

Copeland GP, Jones D, Walters M. POSSUM: a scoring system for surgical audit. Br J Surg. 1991;78(3):355-360. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.