Risk stratification

Question 1

Reasons for risk assessment

Answer 1

Optimise patient to minimise morbidity / mortality

Shared decision making with patient re QOL etc

Appropriate site post op - eg ITU, POCU

Question 2

Options if patient identified as high risk

Answer 2

CPEX clinic
MDT - surgeon, anaesthetist, ITU, patient and NOK

Question 3

Ways to assess patient risk

Answer 3

Clinical judgement
PAC document
Bloods investigations
Grading surgical severity (eg ASA score)
Scoring systems (eg P Possum, SORT)
CPET
Frailty

Question 4

Lee’s revised cardiac risk index

Answer 4

Calculates 30 day risk of death, MI or cardiac arrest

Question 5

Risk scoring systems

Answer 5

P POSSUM
SORT
NELA
ACS-NSQIP

Question 6

Information predicted by ACS-NSQIP

Answer 6

30 day mortality
30 day morbidity
Return to theatre
Readmission
Discharge to post acute care facility

Question 7

Information predicted by P POSSUM, SORT and NELA scores

Answer 7

30 day mortality only