Modeling perioperative risk: can numbers speak louder than words?

Perioperative care is one of the most complex segments of medicine, because it imposes unique and unprecedented stress on the patient and requires the participation of multiple medical specialists. For this reason, the concept of risk management is ideally suited for application in the perioperative period. The authors believe that risk stratification systems applied to perioperative management should address the three dimensions of patient condition, surgical risk and invasiveness, and anesthetic complexity. They have proposed a system that integrates these factors to document and communicate the relevant elements affecting the "shape" of preoperative patients. Admittedly far short of the ideal formula, we hope this nonetheless prompts efforts to establish more uniform means of assessment and communication and provides a foundation for this endeavor. The old adage can be modified: "if your patient rates more than two ASPIRIN, call me before the morning (of surgery)."