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Patterns of Surgical Risk Assessment at a Tertiary Academic Medical Center.

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Hospital medicine consult services show varied approaches to preoperative risk stratification, using multiple tools inconsistently. Standardization is needed to improve patient care and documentation for better surgical outcomes.

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Area of Science:

  • Cardiology
  • Hospital Medicine
  • Surgical Risk Assessment

Background:

  • Preoperative risk stratification is crucial for patient management.
  • Hospital medicine consult services play a role in assessing surgical risk.
  • Current practices may lack standardization.

Purpose of the Study:

  • To review preoperative risk stratification encounters by a hospital medicine consult service.
  • To characterize current practice patterns in risk assessment.
  • To evaluate the need for standardizing risk assessment approaches.

Main Methods:

  • Retrospective chart review of 200 randomly selected patients.
  • Data collected from hospital medicine consult service encounters (2019-2020).
  • Analysis of risk stratification tools and approaches used.

Main Results:

  • 71 preoperative risk assessments were identified among 200 charts.
  • 8 distinct approaches to risk stratification were utilized.
  • Common tools included RCRI, ACS-SRC, and Gupta calculator; 27% used multiple tools, and 15% deviated from guidelines.

Conclusions:

  • Significant heterogeneity exists in preoperative risk stratification practices.
  • There is a need to promote standardization in approach and documentation.
  • Further research should focus on developing consistent risk assessment protocols.