The POSSUM point assignment, morbidity assessment and mortality estimation are those of the original score (above).
Differences from POSSUM score:
(1) peritoneal soiling is replaced by surgical site contamination
(2) operative procedures involves the number done within 30 days
(3) complications (page 736) include unanticipated displacement of a joint implant
(4) warfarin is included as a cardiac sign
(5) timing of operation was elective, urgent or emergency
In the implementation the same assumption was made about the use of the chest X-ray findings (only 1 value for clinical heart failure and X-ray signs of heart failure; only 1 score for respiratory symptoms and X-ray lung findings).
Very major orthopedic surgery (from Table II, page 737):
(1) radical tumor resection
(2) hindquarter or forequarter amputation
(3) major spinal reconstruction
(4) revision of a prosthetic joint in a major joint
Major orthopedic surgery:
(1) amputation of a limb
(2) major joint replacement
(3) arthrodesis of a major joint
(4) ligamentous reconstruction with prosthesis
(5) osteotomy of a long bone
(6) open reduction for a fracture involving a large bone
(7) intervertebral disc surgery (non-laparoscopic)
Intermediate orthopedic surgery:
(1) minor joint replacement
(2) amputation of one or more digits
(3) removal of a small bone
(4) closed reduction of a fracture with external fixation
(5) open reduction for a fracture of a small bone
Minor surgery:
(1) ganglion or bursa removal
(2) fasciotomy
(3) arthroscopic surgery
(4) carpal tunnel surgery or release of entrapped nerve
(5) closed reduction of a fracture
(6) removal of metal
(7) tendon repair
