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Background:  The problem of directly comparing morbidity and mortality rates between institutions without some sort of adjustment for case mix is well documented. Scoring systems have been developed to allow comparisons to be made. The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) is one such system. It was designed to predict operative mortality and morbidity in differing settings and to be independent of case mix. The present study examines the use of POSSUM in colorectal practice in Saudi Arabia.

Methods:  Patients referred to King Faisal Specialist Hospital between 1990 and 1998 for primary management of an histologically proven rectal cancer were identified. POSSUM mortality and morbidity scores and Portsmouth‐Physiological and Operative Severity Score (P‐POSSUM) mortality scores were calculated separately for each patient, and …