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Related Experiment Videos

Comparative audit: the trouble with POSSUM.

S D Bann1, S Sarin

  • 1Department of Surgery, Watford General Hospital, Vicarage Road, Watford WD1 8HB, UK.

Journal of the Royal Society of Medicine
|December 6, 2001
PubMed
Summary
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The Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) is difficult to apply in routine surgical audits. Most patients, even those undergoing surgery, could not be scored, limiting its comparative audit utility.

Area of Science:

  • Surgical outcomes research
  • Healthcare quality improvement

Background:

  • The Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) is a tool for surgical audit.
  • Its feasibility for routine comparative audit requires assessment.

Purpose of the Study:

  • To evaluate the feasibility of applying POSSUM scoring in a real-world clinical setting for comparative audit.

Main Methods:

  • POSSUM scoring was attempted on all patients under two surgeons over six months.
  • Scores were assigned only if necessary POSSUM investigations were performed.
  • Investigations not essential for treatment were avoided.

Main Results:

  • POSSUM scores could be allocated for only 155 out of 521 (30%) operative patients.

Related Experiment Videos

  • The scoring system is procedure-based, excluding non-operative cases.
  • Most operative cases were excluded due to data limitations.

    • Conclusions:

    • POSSUM scoring is impractical for routine comparative surgical audit due to low allocation rates.
    • The system often necessitates additional investigations beyond standard care.
    • POSSUM's utility in broader comparative audit settings is unlikely.