How is risk defined in high-risk surgical patient management?
The definition of risk in surgical patients is a complex and controversial area. Generally risk is poorly understood and depends on past individual and professional perception, and societal norms. In medical use the situation is further complicated by practical considerations of the ease with which risk can be measured; and this seems to have driven much risk assessment work, with a focus on objective measurements of cardiac function. The usefulness of risk assessment and the definition of risk is however in doubt because there are very few studies that have materially altered patient outcome based on information gained by risk assessment. This paper discusses these issues, highlights areas where more research could usefully be performed, and by defining limits for high surgical risk, suggests a practical approach to the assessment of risk using risk assessment tools.
Boyd
Owen
O
The General Intensive Care Unit, The Royal Sussex County Hospital, Brighton, UK. owen.boyd@bsuh.nhs.uk
Jackson
Neil
N
D018806:APACHE; D013502:General Surgery / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017202:Myocardial Ischemia / Q000175:diagnosis; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors