The POSSUM Scoring System for Head and Neck Surgery

 

Operative Severity	Score
endoscopy; tracheostomy; lymph node biopsy; excision of submandibular gland	1
parotidectomy; thyroidectomy; neck dissection for lymph nodes	2
laryngectomy; pharyngectomy	4
free flaps; pedicled flap	8

 

X for morbidity from POSSUM score =

= (0.16 * (physiologic score)) + (0.19 * (operative score)) - 5.91

 

Y for mortality from POSSUM score =

= (0.13 * (physiologic score)) + (0.16 * (operative score)) - 7.04

 

Z for mortality from P-POSSUM score =

= (0.19 * (physiologic score)) + (0.15 * (operative score)) - 9.37

 

Additional variables included in the analysis (all associated with increased post-operative complications):

(1) radiotherapy

(2) previous surgery

(3) malnutrition

 

Performance:

• The POSSUM score was valid for predicting morbidity, and it performed better for high risk patients.

• Neither the POSSUM nor P-POSSUM score performed well for predicting mortality. There was a tendency to overestimate the mortality rate, especially for low risk patients.