Griffiths et al modified the POSSUM score for patients undergoing head and neck surgery. The authors are from the University Hospital of Wales in Cardiff.
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.
Specialty: Critical Care, Emergency Medicine