Graham Paul Copeland

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POSSUM, a Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity, is described. This system has been devised from both a retrospective and prospective analysis and the present paper attempts to validate it prospectively. Logistic regression analysis yielded statistically significant equations for both mortality and(More)
Not surprisingly, internal medicine rather than surgery was popular at that time. Indeed, to many surgeons today, this edict still seems to be exacted in a sublimated way. The outcome of surgical intervention, whether death or uncomplicated survival, complications, or long-term morbidity, is not solely dependent on the abilities of the surgeon in isolation.(More)
We describe the development and validation of a scoring system for auditing orthopaedic surgery. It is a minor modification of the POSSUM scoring system widely used in general surgery. The orthopaedic POSSUM system which we have developed gives predictions for mortality and morbidity which correlate well with the observed rates in a sample of 2326(More)
Overall, supratentorial neurosurgical procedures are associated with a 17% risk of developing postoperative seizures. The incidence varies, but treatment of an arteriovenous malformation, an intracerebral haematoma, a middle cerebral artery aneurysm, an abscess, and meningiomas carry the highest risk. The role of prophylactic anticonvulsant therapy is(More)
UNLABELLED Comparison of outcome after colorectal resection among different surgeons is difficult. Crude rates of morbidity and mortality can be misleading because such rates make no allowance for differences in case mix and fitness of patients. AIM The aim of this study was to compare outcome among five surgeons by means of the simple, well-validated(More)
A 1-year prospective analysis was undertaken of all non-day-case general surgery in a district general hospital. Using the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM) scoring system 3004 patients were assessed. From the predictions of mortality and morbidity so obtained, a quality measure, the ratio of(More)
The euglycaemic glucose clamp technique has been used to assess insulin resistance in patients with colorectal adenocarcinoma. Ten cancer patients were studied and compared with control subjects matched for age, sex and nutritional status. Forty-one euglycaemic clamps were performed at one of five different insulin infusion rates (20, 30, 40, 100 or 200(More)
Comparative audit using overall mortality and morbidity figures can be misleading as they do not take into account variations in surgical procedure and patient fitness. To examine these effects we have compared vascular surgery in two differing hospitals, during a similar 9-month period, using the POSSUM scoring system. In one unit, 255 patients underwent(More)
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(More)