Association between formal preoperative risk assessment and postoperative complications

Area of Science:

• Surgical Risk Assessment
• Patient Outcomes
• Healthcare Quality Improvement

Background:

• Preoperative risk assessment is crucial for patient safety.
• The Surgical Risk Preoperative Assessment System (SURPAS) is a tool designed to evaluate surgical risk.
• Comparing outcomes between patients who did and did not utilize SURPAS is essential for understanding its impact.

Purpose of the Study:

• To compare postoperative complication rates in patients who underwent preoperative assessment with the Surgical Risk Preoperative Assessment System (SURPAS) versus those who did not.
• To evaluate the effectiveness of SURPAS in identifying high-risk surgical patients.

Main Methods:

• A multi-center, propensity-matched study was conducted from 2017 to 2024.
• 1:1 Greedy matching was employed to create comparable cohorts with and without SURPAS utilization.
• Postoperative complications were monitored and compared using the Automated Surveillance of Postoperative Infections and Non-Infections (ASPIN) system.

Main Results:

• Out of 457,117 patients, 5.00% utilized SURPAS.
• The SURPAS cohort exhibited higher rates of older age, ASA class 3-4, and comorbidities, but fewer emergent surgeries.
• After matching, the SURPAS group showed significantly lower mortality (0.71% vs. 1.02%), cardiac (0.34% vs. 0.49%), and renal (0.28% vs. 0.34%) complications, alongside a higher incidence of VTEs (1.46% vs. 1.19%).

Conclusions:

• The Surgical Risk Preoperative Assessment System (SURPAS) may aid in identifying high-risk surgical patients.
• Utilizing SURPAS may lead to care modifications that reduce mortality, cardiac, and renal complications.
• Further research into VTE management in SURPAS-identified patients is warranted.