# Application of POSSUM scores in post-operative complication assessment in patients undergoing general surgery: a retrospective study

**Authors:** Nan Chen, Jianning Zhai, Yuhe Zhou, Yugang Lv

PMC · DOI: 10.1186/s12893-025-03462-y · BMC Surgery · 2026-01-24

## TL;DR

This study shows that the POSSUM scoring system can effectively predict postoperative complications in general surgery patients at county-level hospitals.

## Contribution

The study validates the POSSUM model's utility in predicting complications in general surgery at a county-level hospital setting.

## Key findings

- The overall postoperative complication rate was 10.0%, with abdominal/pelvic infections being most common.
- The POSSUM model demonstrated good predictive ability for postoperative complications.
- Sex, respiratory score, pulse score, urea nitrogen level, surgery size, and malignancy score were identified as independent risk factors.

## Abstract

This study aimed to evaluate the efficacy of the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) model in predicting postoperative complications among patients who underwent general surgery at a county-level hospital.

A retrospective analysis was conducted on 401 patients admitted to the general surgery department of Bahrain Right Banner Hospital from January 2000 to April 2023. POSSUM scores were calculated based on preoperative physiological and operative severity factors. Postoperative complications were recorded and classified using the Clavien‒Dindo system.

The overall postoperative complication rate was 10.0%, with abdominal/pelvic infections being the most common complication (5.7%). Univariate and multivariate analyses identified sex, respiratory score, pulse score, urea nitrogen level, surgery size, and malignancy score as independent risk factors for complications. The POSSUM model demonstrated good predictive ability for postoperative complications.

The POSSUM scoring system is a valuable tool for predicting postoperative complications in patients undergoing general surgery at county-level hospitals, enabling health care providers to identify high-risk patients and implement preventive measures. Future studies should explore the effectiveness of targeted interventions based on POSSUM scores to further improve patient outcomes.

## Full-text entities

- **Diseases:** complication (MESH:D008107)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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Source: https://tomesphere.com/paper/PMC12910978