ACCÈS MEMBRES
Identifiant :  
Mot de passe :
> Numéro d'adhérent ou mot de passe oublié
> Devenir membre de la SFAR



LES AFAR


Inscrivez-vous à nos newsletters



Sondage SFAR - Précédents sondages


separateur


Ce site respecte les principes de la charte HONcode de HON 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:

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


Age
Glasgow (Help)
Respiratory
Urea
Pulse (beats/min)
Cardiac signs
Hb (g/dL)
W.B.C.
ECG
Potassium (mEql/L)
Sodium (mEql/L)
Systolic Blood Pressure
Physiologic Score


Operative Severity (help)
Multiple procedures
Total Blood Loss
Peritoneal soiling
Cancer
Mode of surgery
Operative Score

Predicted Morbidity Rate
(Definitions are following)
  Predicted Mortality Rate
x = (0.16* physiologic score)+(0.19*operative score)- 5.91
Predicted Morbidity Rate = 1/(1+ e(-x))
y = (0.13* physiologic score)+(0.16*operative score)-7.04
Predicted Mortality Rate = 1/(1+ e(-y))

Ref : Copeland GP et al. POSSUM : a scoring system for surgical audit. Br J Surg. 1991;78: 356-60. 

Morbidity : definitions 

Wound haemorrhage : local haematoma requiring evacuation.
Deep haemorrhage: postoperative bleeding requiring re-exploration.
Chest infection: production of purulent sputum with positive bacteriological cultures, with or without chest radiography changes or pyrexia, or consolidation seen on chest radiograph.
Wound infection : wound cellulitis or the discharge of purulent exsudate.
Urinary infection: the presence of > 10 5 bacteria / ml with the presence of withe cells in the urine, in previously clear urine.
Deep infection: the presence of an intra-abdominal collection confirmed clinically or radiologically.
Septicaemia :
positive blood culture.
Pyrexia of unknown origin : any temperature above 37° C for more than 24 h occuring after the original pyrexia following surgery (if present) had settled , for which no obvious cause could be found.
Wound dehiscence : superficial or deep wound breakdown.
Deep venous thrombosis and pulmonary embolus : when suspected, confirmed radiologically by venography or ventilation/ perfusion scanning or diagnosed at post mortem.
Cardiac failure : symptoms or signs of left ventricular or congestive cardiac failure ( alteration from preoperative measures)
Impaired renal function : arbitrarily defined as an increase in blood urea of > 5 mmol / l from preoperative levels .
Hypotension : a fall in systolic blood pressure below 90 mmHg for more than 2 H as determined by sphygmomanometry or arterial pressure transducer measurement
Respiratory failure : respiratory difficulty requiring emergency ventilation.
Anastomotic leak : discharge of bowel content via the drain, wound or abnormal orifice.

<< Back to the scores page

Back to 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 POSSUM

<< Back to the scores page

SFAR - Société Française d’Anesthésie et de Réanimation - 74 Rue Raynouard, 75016 PARIS - Tél. : 01 45 25 82 25 Télécopie : 01 40 50 35 22
Mentions légales - Charte éditoriale - Contactez-nous