Tools for Clinical History-Taking

Fact sheet
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British Geriatrics Society
Date Published:
05 July 2018
Last updated: 
05 July 2018

The following are validated tools (all in pdf format) which may be useful in augmenting clinical history-taking as part of comprehensive geriatric assessment (CGA), or as screening tools to trigger the need for an in-depth assessment.

ASA Physical Classification System

I Healthy patient
II Mild systemic disease - no functional limitation
III Severe systemic disease - definite functional limitation
IV Severe systemic disease that is a constant threat to life
V Moribund patient not expected to survive without the operation

POSSUM (scoring system for predicting mortality in surgical patients) Parameters included in the scoring system:

  • Physiological parameters
  • Age
  • Cardiac signs
  • Systolic BP
  • Pulse
  • Glasgow coma scale
  • Haemaglobin
  • WCC
  • Urea
  • Sodium
  • Potassium
  • Electrocardiogram
  • Operative parameters
  • Operative severity
  • Multiple procedures
  • Total blood loss
  • Peritoneal soiling
  • Presence of malignancy
  • Mode of surgery

Predictive mortality score using the equation: ln [R/(1−R) = −7.04 + 0.13 × physiological score + 0.16 x operative score; where R is the predicted mortality score.

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