Preoperative Mortality Predictor (PMP) Score
PMP Calculator
Age
ASA Physical Status
Functional Status
Emergency Surgery
Sepsis Status
PMP Score:
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Predicts risk of perioperative mortality in general surgery patients.
Why Use
Uses easily obtainable information preoperatively. Derived to aid in preoperative counseling and discussions of informed consent.
When to Use
Use in patients ≥18 years old undergoing general surgery (elective or emergent).
Formula
Addition of the selected points: Variable Points Inpatient No 0 Yes 6 Sepsis No 0 Yes 4 Poor functional status (total assistance required for all daily activities) No 0 Yes 3 Disseminated cancer No 0 Yes 1 Age, years <65 0 65-69 0.5 70-79 1 ≥80 2 Cardiac comorbidity (dyspnea and CHF history, past MI or angina, peripheral artery disease, hypertension requiring medication) No 0 Yes 5 Pulmonary comorbidity (on ventilator, COPD history, current pneumonia) No 0 Yes 3 Renal comorbidity (dialysis, renal failure) No 0 Yes 1 Liver comorbidity (ascites, esophageal varices) No 0 Yes 1 Steroids for chronic condition No 0 Yes 1 Weight loss (>10% body weight in last 6 months) No 0 Yes 1 Bleeding disorder No 0 Yes 1 DNR status No 0 Yes 1 Obesity No 0 Yes -1
Pearls / Pitfalls
Study looked at ACS NSQIP data for 7 operations: open pancreas, open/laparoscopic colorectal, hernia (ventral, umbilical, or inguinal), and gallbladder surgeries. Similar to POSSUM and APACHE II scoring systems, though with fewer variables. We are not aware of any head-to-head studies comparing this score to the others.
Advice
Could potentially be used as a measure of systems quality.
More Information
Interpretation: PMP Score Risk of perioperative mortality -1-5 0.1% 6-10 0.6% 11-15 2.4% 16-20 12.6% 21-25 37.5% 26-30 40.0%