Les thèmes du moment

antibioprophylaxie Votre recherche Maladie thrombo-embolique polytraumatisé sdra Anti-aggrégeants transfusion sepsis Stents

Ce site respecte les principes de la charte HONcode.
Site certifié en partenariat avec la Haute Autorité de Santé (HAS).
Vérifiez ici.

Ressources et utilitaires

Scoring systems for ICU and surgical patients:

Portsmouth - POSSUM
(Physiologic and Operative Severity Score for the enUmeration of Mortality and Morbidity) 

Age <= 60 61 - 70 >= 71	Glasgow (Help) 15 12 - 14 9 - 11 < or = 8	Respiratory (1pt) No dyspnoea (2pts) Dyspnoea on exertion (2pts) Mild COPD on chest RX (4pts) Limiting dyspnoea (1 flight) (4pts) Moderate COPD on chest RX (8pts) Dyspnoea on rest (F>=30/') (8pts) Fibrosis or Consolidation
Urea < or = 7.5 mmol/L 7.6-10 mmol/L 10.1-15 mmol/L >or= 15.1 mmol/L	Pulse (beats/min) < or = 39 < 40-49 50-80 81-100 101-120 > or = 121	Cardiac signs (1pt) No failure (2pts) Diuretics, digoxin (2pts) Antianginal Antihypertensive (4pts) Peripheral oedema / Warfarine (4pts) Borderline cardiomegaly (8pts) Raised Jugular venous Press. (8pts) Cardiomegaly
Hb (g/dL) < or = 9.9 10-11.4 11.5-12.9 13-16 16.1-17 17.1-18 > or = 18.1	W.B.C. < or = 3000/ mm3 3100-3999 /mm3 4000-10000/mm3 10100-20000/mm3 > or = 20100/mm3	ECG (1pt) Normal (4pts) AF + Rate = 60-90 (8pts) Anyother abnormal rythm (8pts) 5 or more EVS/min (8pts) Q Waves or ST-T changes
Potassium (mEql/L) < or = 2.8 2.9-3.1 3.2-3.4 3.5-5.0 5.1-5.3 5.4-5.9 > or = 6.0	Sodium (mEql/L) < or = 125 126-130 131-135 > or = 136	Systolic Blood Pressure < or = 89 mmHg 90-99 mmHg 100-109 mmHg 110-130 mmHg 131-170 mmHg > or = 171 mmHg
Physiologic Score

Operative Severity (Help) Minor Moderate Major Major +	Multiple procedures 1 2 > 2	Total Blood Loss < or = 100 mL 101-500 mL 501-999 mL > or = 1000 mL
Peritoneal soiling None Minor (serous fluid) Local pus free bowel cont.pus or blood	Cancer None Primary only Nodal metastases. Distant metastases	Mode of surgery Elective Emergency (Possibly > 2H) Surgery< 24 H after adm. Emergency (< 2H needed)
Operative Score

Predicted Death Rate

R= (0.1692 * physiologic score)+(0.1550 *operative score)-9.065 Predicted Death Rate = 1 / ( 1+ e(-R) )

References :

Copeland GP et al. POSSUM : a scoring system for surgical audit. Br J Surg. 1991;78:356-360.
Prytherch DR et al. POSSUM and Portsmouth POSSUM for predicting mortality. Br J Surg. 1998;85:1217-20

<< Back to the scores page

Back to P-POSSUM

Moderate surgery : cholecystectomy, appendicectomy, mastectomy, transurethral resection of prostate
Major surgery : any laparotomy , bowel resection, cholecystectomy with choledochotomy, peripheral vascular procedure or major amputation
Major surgery + : any aortic procedure, abdominoperineal resection, pancreatic or liver resection, oesophagogastrectomy.

Eyes Open	Verbal	Motor
Spontaneous To speech To pain Absent	Converses / Oriented Converses / Disoriented Inappropriate Incomprehensible Absent	Obeys Localizes pain Withdraws (flexion) Decorticate (flexion) rigidity Decerebrate (extension) rigidity Absent

Glasgow=

Back to P- POSSUM

<< Back to the scores page