Related Experiment Video
Updated: Aug 16, 2026
Single-port Robotic Transanal Total Mesorectal Excision in a Porcine Model (Sus scrofa domesticus)
Published on: April 3, 2026
Comparison of Surgical Risk Score, POSSUM and p-POSSUM in higher-risk surgical patients
M J Brooks1, R Sutton, S Sarin
1Department of Surgery, Watford General Hospital, Watford, UK.
Background:
Much current interest is focused on the use of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) and the Portsmouth predictor equation (p-POSSUM) for risk-adjusted surgical audit. The Surgical Risk Score (SRS) has been shown to offer an equivalent accuracy, but was validated using a cohort that contained a high proportion of low-risk patients. The aim of this study was to compare the accuracy of mortality prediction using SRS with that of POSSUM and p-POSSUM in a cohort of higher-risk patients.
Methods:
Some 949 consecutive patients undergoing inpatient surgical procedures in a district general hospital under the care of a single surgeon were analysed.
Results:
The observed 30-day mortality rate was 8.4 per cent. Mean mortality rates predicted using SRS, POSSUM and p-POSSUM scores were 5.9, 12.6 and 7.3 per cent respectively. No significant difference was observed in the area under the receiver-operator characteristic curves for the three methods.
Conclusion:
The SRS accurately predicted mortality in higher-risk surgical patients. The accuracy of prediction equalled that of POSSUM and p-POSSUM.