The use of orthopaedic POSSUM as an audit tool for fractured neck of femur.

In this prospective study, 230 patients who were operated on for a fractured neck of femur were evaluated using the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM). We observed 25 deaths (10.9%) and 95 patients had a post-operative complication (41.3%). The orthopaedic POSSUM equations yielded an overall predicted mortality of 21 patients and morbidity in 106 patients. This gave observed to expected (O:E) ratios of 1.19 and 0.95 respectively meaning that POSSUM agreed well with the observed mortality and morbidity. We concluded that POSSUM accurately predicts mortality and morbidity in patients with femoral neck fractures and when used as an audit tool would provide a fairer system of comparison and would allow an unbiased interpretation of results when changes in patient management are made.