PREOPERATIVE RISK ASSESSMENT IN ELECTIVE GENERAL-SURGERY

Despite improved surgical techniques there is still a risk of mortalit y in elective general surgery. In a prospective study preoperative dat a from 3250 patients were collected and compared with postoperative sy stemic complications, using univariate chi(2) analysis, Highly signifi cant (P<0.00001) variables were subjected to stepwise logistic regress ion analysis. The severity of operative procedure, higher American Soc iety of Anesthesiologists (ASA) grade, symptoms of respiratory disease and malignancy were found to be significant risk factors predicting p ostoperative morbidity (P<0.05). Using these four variables, a simple preoperative risk scoring system has been defined. Class A (up to 5 po ints) was defined as a low-risk group (systemic complication rate 5.0 per cent), class B (5-7 points) was intermediate risk (systemic compli cation rate 17.9 per cent) and class C (8-10 points) was high risk (sy stemic complication rate 33.3 per cent), Patients at high risk for per ioperative and postoperative complications are more likely to be ident ified by this analysis than by using the ASA classification alone.