There Should Be More To Life Than Death

An examination of new methods of outcome determination

Mr Graham Copeland MB BS FRCS ChM Consultant General Surgeon
Mrs Christina Richardson Dip HE SHND Critical Care Nurse


Death following surgical intervention is widely used as an outcome measure and has been used for nearly four thousand years in various forms. The current paper examines some of the problems with using raw mortality rates and methodologies using low numbers of risk adjusted variables and some of the potential solutions using more refined mathematical…

  • 28 Feb, 2014
  • Russell
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Emergency Surgery: Standards for unplanned surgical care and the introduction of pre-assessment units

Following the publication of ‘Taking care in an emergency’ in the June addition of HSJ, we thought it appropriate to comment on how our COMPASS module can support the Royal College of Surgeons new standards and guidance for delivering this type of care, which can be found here:

The necessity for every hospital to have a reliable surgical assessment unit for Emergency Care is paramount, given the nature of the patients’ state of health as they are often the…

  • 20 Nov, 2013
  • Claire Bale
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A 5 Year Audit of the High Risk General Surgical Patient

Claire Martin MB, BS, FRCS
Joanna Seward MB, BS, FRCS
Graham O’Dair MB, BS, FRCS
Graham Copeland MB, BS, FRCS, ChM Consultant Surgeon North Cheshire Hospitals NHS Trust

Keywords: Audit, POSSUM scoring system, high risk surgical patient


The current study represents a five year audit of the surgical high risk patient (predicted risk over 10%) and the effects of service provision and clinical practice on ultimate mortality and morbidity.

14890 consecutive non-day procedures were scored using the POSSUM scoring system during this period of which…

  • 18 Feb, 2010
  • Claire Bale
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An Assessment of the POSSUM System in Orthopaedic Surgery

Mohamed K FRCS*, Copeland GP ChM**, Boot DA FRCS***,
Casserley HC FRCS***, Shackleford IM FRCS*** Sherry PG FRCS***,
Stewart GJ FRCS***

*Orthopaedic Registrar, Warrington Hospital
** Consultant General Surgeon, Warrington Hospital
*** Consultant Orthopaedic Surgeon, Warrington Hospital

Key words: Orthopaedic surgery, Surgical audit, POSSUM scoring system

First revision 11.12.2001


The present article describes the development and validation of a scoring system for orthopaedic surgical audit. The present system is a minor modification of the established POSSUM scoring system widely used in general surgery. The orthopaedic POSSUM system…

  • 15 Feb, 2010
  • Claire Bale
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