Key result
Among 71 preoperative risk assessments, significant heterogeneity was observed with 8 distinct approaches utilized, most commonly the Revised Cardiac Risk Index (77%), and 27% using multiple tools.
Why the study?
Practice patterns for preoperative risk stratification encounters performed by a hospital medicine consult service needed characterization to evaluate the need for a standardized approach.
Observational (n=200)
No
Preoperative risk stratification practices by hospital medicine consult services show significant heterogeneity, indicating a need for standardized approaches.
Objective: Review preoperative risk stratification encounters performed by a hospital medicine consult service at a tertiary academic medical center to better characterize practice patterns and evaluate the need to standardize our approach to risk assessment. Methods: Retrospective chart review of 200 randomly selected patients representing approximately 40% of all patients seen by the hospital medicine consult service from 2019-2020. Results: Of the 200 charts reviewed, there were 71 preoperative risk assessments performed and 8 distinct approaches utilized. The most common risk stratification tool used was the Revised Cardiac Risk Index (RCRI), followed by the American College of Surgeons-Surgical Risk Calculator (ACS-SRC) and then the Gupta Myocardial Infarction and Cardiac Arrest calculator. 19 encounters (27%) used multiple risk stratification tools, while 11 encounters (15%) were not consistent with American College of Cardiology/American Heart Association guidelines. Conclusion: Significant heterogeneity exists within preoperative risk stratification practices in this single-center study. Follow-up work remains to promote standardization in approach and documentation.
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Murray et al. (2023) conducted an observational in Preoperative risk stratification (n=200). Preoperative risk stratification tools was evaluated on Proportion of encounters using specific preoperative risk stratification tools. Among 71 preoperative risk assessments, significant heterogeneity was observed with 8 distinct approaches utilized, most commonly the Revised Cardiac Risk Index (77%), and 27% using multiple tools.
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