Britany L. Raymond|Jonathan P. Wanderer|Alexander T. Hawkins|Timothy M. Geiger|Jesse M. Ehrenfeld|John W. Stokes|Matthew D. McEvoy
Use of the American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator During Preoperative Risk Discussion: The Patient Perspective
Vanderbilt University Medical Center|Vanderbilt University Medical Center|Vanderbilt University Medical Center
background american college surgeons acs national surgical quality improvement program surgical risk calculator acs calculator provides empirically derived patientspecific risks common adverse perioperative outcomes acs calculator promoted tool improve shared decisionmaking informed consent patients undergoing elective operations however knowledge data exist regarding use tool actual preoperative risk discussions patients accordingly performed survey assess 1 whether patients find tool easy interpret 2 accurately patients predict surgical risks 3 impact risk disclosure levels anxiety future motivations decrease personal risk methods patients n 150 recruited preoperative clinic completed initial survey estimated hospital length stay personal perioperative risks 12 clinical complications analyzed acs calculator next risk calculation performed entering participants demographics acs calculator participants reviewed individualized risk reports detail completed followup survey evaluate perceptions results nearly 90 participants desire review acs calculator report future surgical consents highrisk patients 3 times likely underestimate risk complication serious complication length stay compared lowrisk patients p lt 001 reviewing calculated risks 70 stated would consider participating prehabilitation decrease perioperative risk nearly 40 would delay surgery knowledge personal acs risk calculations effect anxiety 20 decreased anxiety 71 participants conclusions acs calculator may particular benefit highrisk surgical populations providing realistic expectations outcomes recovery use tool may also provide motivation patients participate risk reduction strategies