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Mortality control charts: Both components of POSSUM ratio require critical analysis

BMJ 2003; 326 doi: (Published 19 June 2003) Cite this as: BMJ 2003;326:1397
  1. George A Khoury, consultant surgeon (
  1. Conquest Hospital, East Sussex NHS Trust, St Leonards on Sea, TN37 7RD

    EDITOR—Mean mortality of almost 10% and 30% (max 50%) is reported for elective and emergency gastro-oesophageal surgery in 29 units.1 Yet none had underperformed. A benchmark is set even though institutions were not randomised.

    A multifactorial model is created by using POSSUM to fit this dataset.2 POSSUM's overpredicting tendency …

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