Orthopaedic POSSUM Scoring System: an Assessment of the Risk of Debridement in Patients with Pressure Sores

We hypothesised that the implementation of a validated method of audit, the Physiological and Operative Severity Score for enUmeration of Mortality and morbidity (POSSUM), would be useful in the evaluation of the risks of debridement in bedridden patients with pressure ulcers. With the orthopaedic version of POSSUM (O-POSSUM), physiological data and an operative profile are scored to predict mortality for 30 days postoperatively. Fourteen cases were analysed retrospectively. The difference in predicted mortality was compared with those who died and those who survived. The mean (SD) predicted mortality among those who died was 47 (16)%, and among those who lived was 18 (14)%. Those who died were classified as a relatively high risk group, and the values differed significantly (p=0.01). O-POSSUM may be helpful in audit.