The surgical team needs to discuss risks of the surgery or procedure with the patient and family or carer.
A perioperative risk assessment considers surgical complexity, the urgency of the surgery or procedure and individual patient comorbidities.
Surgical complexity categories include ‘minor’, ‘common and intermediate’, ‘major’ and ‘complex major’. An indicative list of surgery (minor to complex major) for both adults and children is available in the Guide to the Role Delineation of Clinical Services.
The perioperative risk assessment may have implications for informed consent and pre-procedure planning. It can help guide where the patient will go after their surgery or procedure, e.g. high dependency, close observation or intensive care unit placement.1
A patient who is identified as high risk for surgery can be referred to a high-risk clinic for multidisciplinary assessment and management, and to improve their perioperative care and outcomes.
Resources
ARISCAT Score of Postoperative Pulmonary Complications
Predicts the risk of pulmonary complications after surgery, including respiratory failure.
Source: MDCalc
Duke Activity Status Index (DASI)
Estimates functional capacity.
Source: MDCalc
Frailty screening and assessment tools
Five screening and assessment tools for frailty.
Source: Agency for CIinical Innovation
P-POSSUM (Portsmouth physiological and operative severity score for the enumeration of mortality and morbidity) calculator
Calculates the risk of morbidity and mortality for general surgical patients.
Source: Risk Prediction in Surgery UK
Revised Cardiac Risk Index for Pre-Operative Risk
Evaluates the risk of cardiac complications after noncardiac surgery.
Source: MDCalc
STOP BANG Questionnaire
Screens people for obstructive sleep apnoea.
Source: NSW Health
Surgical Outcome Risk Tool
Estimates the risk of death within 30 days of an operation.
Source: Surgical Outcomes Research Centre UK
Surgical Risk Calculator
Estimates a patient’s risk of postoperative complications.
Source: American College of Surgeons National Surgical Quality Improvement Program
References
- NSW Ministry of Health. Policy directive: Interpreters - Standard procedures for working with health care interpreters. NSW, Australia: NSW Ministry of Health; 19 Dec 2017 [cited 28 Mar 2024].