THE CMG VOICE

ACS Surgical Risk Calculator a handy tool to determine how risky surgery will be

Recently I received an email alerting me to a website apparently affiliated or run by the American College of Surgeons. Here it is:

[Surgical Risk Calculator](http://riskcalculator.facs.org/)

It is a four step process by which a doctor or patient can input information and get a quick estimate of the risk of various bad things happen given a particular surgery.

On occasion our office handles claims involving surgeries, including claims that the patient was not a good candidate for surgery based on his or her pre-surgical state of health. This tool may be useful in looking back, putting ourselves in the place of the surgeon and the patient at a time prior to surgery, with the information available, and see what the risks for various complications were. This would include, in all likelihood, the complication that in fact occurred and the reason the person is consulting with us about a possible case.

The Risk Calculator asks for information, including the proposed surgery, whether there are other options besides surgery, and questions aimed at the general health of the surgical candidate.

From that information, it calculates the risk of various adverse outcomes occurring, including general things like “Serious Complication,” and more specific complications like “Surgical Site Infection”, “Urinary Tract Infection”, and “Venous Thromboembolism”. The Calculator estimates the chance of each negative outcome occurring, as well as whether the chance is above or below average for that procedure.

I have not seen this or a similar Risk Calculator used in any of my cases as part of the informed consent process, but I can see this being a useful part of the process. For patients, it illustrates in detail and specifically with respect to their case the possible bad outcomes of surgery. For surgeons, it can be useful evidence in support of the claim that the patient was fully informed prior to surgery, including (if applicable) of the exact complication he or she is now complaining of.