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  "description": "Copeland 1991 POSSUM surgical audit: 12 physiologic and 6 operative 1/2/4/8 items (age has no 8; ECG has no 2). Returns physiologic_score, operative_score, and estimated morbidity and mortality percents from the unrounded Copeland logits. Not P-POSSUM (Whiteley), not a diagnosis, not operative consent. magent does not examine the patient.",
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                "blood_loss_ml": 50,
                "cardiac": "no_failure",
                "ecg": "normal",
                "gcs": 15,
                "hemoglobin_g_dl": 14,
                "malignancy": "none",
                "mode_of_surgery": "elective",
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                "operative_severity": "minor",
                "peritoneal_soiling": "none",
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                "sodium_mmol_l": 140,
                "systolic_bp_mm_hg": 120,
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                  "title": "POSSUM: a scoring system for surgical audit"
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                "estimated_mortality_percent": 1.08,
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                "mortality_logit": -4.52,
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                "mortality_logit": -4.52,
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                "physiologic_score": 12
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                        "blood_loss_ml": {
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                          "description": "Copeland 1991 cardiac signs as assigned by the caller: no_failure (1); diuretic_digoxin_antianginal_or_hypertensive (2); peripheral_edema_warfarin_or_borderline_cardiomegaly (4); raised_jvp_or_cardiomegaly (8). magent does not examine the patient.",
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                          "description": "Copeland 1991 electrocardiogram as assigned by the caller: normal (1); atrial_fibrillation_60_90 (4); other_abnormal_or_ectopics_or_q_st_t (8). No 2-point cell. magent does not interpret a tracing.",
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                          "description": "Glasgow Coma Scale total as assigned by the caller, integer 3-15. 15 → 1; 12-14 → 2; 9-11 → 4; ≤8 → 8. magent does not examine the patient.",
                          "type": "integer"
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                        "hemoglobin_g_dl": {
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                          "type": "number"
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                        "malignancy": {
                          "description": "Copeland 1991 presence of malignancy as assigned by the caller: none (1); primary_only (2); nodal_metastases (4); distant_metastases (8). magent does not diagnose.",
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                          "description": "Copeland 1991 mode of surgery as assigned by the caller: elective (1); emergency_resuscitation_gt_2h_or_lt_24h (4); immediate_lt_2h (8). No 2-point cell.",
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                        "operative_severity": {
                          "description": "Copeland 1991 Table 2 operative severity as assigned by the caller: minor (1); moderate (2); major (4); major_plus (8). magent does not classify an operative note.",
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                            "moderate",
                            "major",
                            "major_plus"
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                          "type": "string"
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                        "peritoneal_soiling": {
                          "description": "Copeland 1991 peritoneal soiling as assigned by the caller: none (1); minor_serous (2); local_pus (4); free_bowel_pus_blood (8). magent does not examine the patient.",
                          "enum": [
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                            "local_pus",
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                        "pulse": {
                          "description": "Pulse in beats/min, integer 20-250. 50-80 → 1; 81-100 → 2; 40-49 or 101-120 → 4; ≤39 or ≥121 → 8. magent does not measure pulse.",
                          "type": "integer"
                        },
                        "respiratory": {
                          "description": "Copeland 1991 respiratory history as assigned by the caller: no_dyspnea (1); exertional_or_mild_coad (2); limiting_or_moderate_coad (4); rest_or_fibrosis_consolidation (8). magent does not examine the patient.",
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                        "sodium_mmol_l": {
                          "description": "Serum sodium in mmol/L (90-200). ≥136 → 1; 131-135 → 2; 126-130 → 4; ≤125 → 8.",
                          "type": "number"
                        },
                        "systolic_bp_mm_hg": {
                          "description": "Systolic blood pressure in mm Hg (20-300). 110-130 → 1; 100-109 or 131-170 → 2; 90-99 or ≥171 → 4; ≤89 → 8. magent does not measure blood pressure.",
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                        "urea_mmol_l": {
                          "description": "Serum urea in mmol/L (0.5-80). ≤7.5 → 1; 7.6-10.0 → 2; 10.1-15.0 → 4; ≥15.1 → 8.",
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                  "estimated_morbidity_percent": 5.47,
                  "estimated_mortality_percent": 1.08,
                  "formula": "possum",
                  "formula_expression": "physiologic_score = sum of 12 Copeland 1991 Table 1 items (1/2/4/8; age has no 8, ECG has no 2); operative_score = sum of 6 Table 2 items (1/2/4/8; multiple_procedures and mode_of_surgery have no 2); ln[R/(1-R)] morbidity = -5.91 + 0.16*physiologic_score + 0.19*operative_score; ln[R/(1-R)] mortality = -7.04 + 0.13*physiologic_score + 0.16*operative_score; estimated_morbidity_percent and estimated_mortality_percent = 100 * exp(logit)/(1+exp(logit)) from the unrounded logit",
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                  "citation": {
                    "authors": "Copeland GP, Jones D, Walters M",
                    "doi": "10.1002/bjs.1800780327",
                    "id": "copeland-1991",
                    "pmid": "2021856",
                    "source": "Br J Surg. 1991;78(3):355-360",
                    "title": "POSSUM: a scoring system for surgical audit"
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                      "value": 50
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                      "points": 1,
                      "present": true,
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                      "points": 1,
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                      "points": 1,
                      "present": true,
                      "value": 120
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                      "points": 1,
                      "present": true,
                      "value": 70
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                      "points": 1,
                      "present": true,
                      "value": 15
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                      "points": 1,
                      "present": true,
                      "value": 14
                    },
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                      "points": 1,
                      "present": true,
                      "value": 8
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                      "points": 1,
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                      "value": 5
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                      "points": 1,
                      "present": true,
                      "value": 140
                    },
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                      "points": 1,
                      "present": true,
                      "value": 4
                    },
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                      "points": 1,
                      "present": true,
                      "value": "normal"
                    },
                    {
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                      "points": 1,
                      "present": true,
                      "value": "minor"
                    },
                    {
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                      "points": 1,
                      "present": true,
                      "value": "one"
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                      "value": "none"
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                    {
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                      "points": 1,
                      "present": true,
                      "value": "elective"
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                  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
                  "estimated_morbidity_percent": 5.47,
                  "estimated_mortality_percent": 1.08,
                  "formula": "possum",
                  "formula_expression": "physiologic_score = sum of 12 Copeland 1991 Table 1 items (1/2/4/8; age has no 8, ECG has no 2); operative_score = sum of 6 Table 2 items (1/2/4/8; multiple_procedures and mode_of_surgery have no 2); ln[R/(1-R)] morbidity = -5.91 + 0.16*physiologic_score + 0.19*operative_score; ln[R/(1-R)] mortality = -7.04 + 0.13*physiologic_score + 0.16*operative_score; estimated_morbidity_percent and estimated_mortality_percent = 100 * exp(logit)/(1+exp(logit)) from the unrounded logit",
                  "morbidity_logit": -2.85,
                  "mortality_logit": -4.52,
                  "operative_score": 6,
                  "physiologic_score": 12
                }
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                          "blood_loss_ml": {
                            "description": "Total blood loss in mL (0-20000). ≤100 → 1; 101-500 → 2; 501-999 → 4; ≥1000 → 8. Table 2 writes <100 then 101-500; 100 mL is scored with the lowest band.",
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                          "cardiac": {
                            "description": "Copeland 1991 cardiac signs as assigned by the caller: no_failure (1); diuretic_digoxin_antianginal_or_hypertensive (2); peripheral_edema_warfarin_or_borderline_cardiomegaly (4); raised_jvp_or_cardiomegaly (8). magent does not examine the patient.",
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                            "description": "Copeland 1991 electrocardiogram as assigned by the caller: normal (1); atrial_fibrillation_60_90 (4); other_abnormal_or_ectopics_or_q_st_t (8). No 2-point cell. magent does not interpret a tracing.",
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                            "description": "Glasgow Coma Scale total as assigned by the caller, integer 3-15. 15 → 1; 12-14 → 2; 9-11 → 4; ≤8 → 8. magent does not examine the patient.",
                            "type": "integer"
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                          "hemoglobin_g_dl": {
                            "description": "Haemoglobin in g/dL (3-25). 13-16 → 1; 11.5-12.9 or 16.1-17.0 → 2; 10.0-11.4 or 17.1-18.0 → 4; ≤9.9 or ≥18.1 → 8.",
                            "type": "number"
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                          "malignancy": {
                            "description": "Copeland 1991 presence of malignancy as assigned by the caller: none (1); primary_only (2); nodal_metastases (4); distant_metastases (8). magent does not diagnose.",
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                          "mode_of_surgery": {
                            "description": "Copeland 1991 mode of surgery as assigned by the caller: elective (1); emergency_resuscitation_gt_2h_or_lt_24h (4); immediate_lt_2h (8). No 2-point cell.",
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                            "description": "Number of procedures as assigned by the caller: one (1); two (4); more_than_two (8). No 2-point cell.",
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                              "two",
                              "more_than_two"
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                          "operative_severity": {
                            "description": "Copeland 1991 Table 2 operative severity as assigned by the caller: minor (1); moderate (2); major (4); major_plus (8). magent does not classify an operative note.",
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                              "moderate",
                              "major",
                              "major_plus"
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                            "type": "string"
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                          "peritoneal_soiling": {
                            "description": "Copeland 1991 peritoneal soiling as assigned by the caller: none (1); minor_serous (2); local_pus (4); free_bowel_pus_blood (8). magent does not examine the patient.",
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                              "none",
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                          "potassium_mmol_l": {
                            "description": "Serum potassium in mmol/L (1-12). 3.5-5.0 → 1; 3.2-3.4 or 5.1-5.3 → 2; 2.9-3.1 or 5.4-5.9 → 4; ≤2.8 or ≥6.0 → 8.",
                            "type": "number"
                          },
                          "pulse": {
                            "description": "Pulse in beats/min, integer 20-250. 50-80 → 1; 81-100 → 2; 40-49 or 101-120 → 4; ≤39 or ≥121 → 8. magent does not measure pulse.",
                            "type": "integer"
                          },
                          "respiratory": {
                            "description": "Copeland 1991 respiratory history as assigned by the caller: no_dyspnea (1); exertional_or_mild_coad (2); limiting_or_moderate_coad (4); rest_or_fibrosis_consolidation (8). magent does not examine the patient.",
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                              "exertional_or_mild_coad",
                              "limiting_or_moderate_coad",
                              "rest_or_fibrosis_consolidation"
                            ],
                            "type": "string"
                          },
                          "sodium_mmol_l": {
                            "description": "Serum sodium in mmol/L (90-200). ≥136 → 1; 131-135 → 2; 126-130 → 4; ≤125 → 8.",
                            "type": "number"
                          },
                          "systolic_bp_mm_hg": {
                            "description": "Systolic blood pressure in mm Hg (20-300). 110-130 → 1; 100-109 or 131-170 → 2; 90-99 or ≥171 → 4; ≤89 → 8. magent does not measure blood pressure.",
                            "type": "number"
                          },
                          "urea_mmol_l": {
                            "description": "Serum urea in mmol/L (0.5-80). ≤7.5 → 1; 7.6-10.0 → 2; 10.1-15.0 → 4; ≥15.1 → 8.",
                            "type": "number"
                          },
                          "wbc_k_ul": {
                            "description": "White cell count in ×10^9/L (0.1-100). 4.0-10.0 → 1; 10.1-20.0 or 3.1-3.9 → 2; ≥20.1 → 4; ≤3.0 → 8. Table 1 lists 3.1-4.0 on the 2-point cell; 4.0 is scored in the 1-point band.",
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