Identifying high-risk surgical patients

The number of deaths associated with surgery and anaesthesia remains remarkably constant despite developments in investigative technology and anaesthetic and surgical techniques. Cardiac and respiratory disease are present in the majority of cases. Numerous studies have analysed the relationship between pre-operative historical factors, findings on specialized investigation and multivariate risk scoring systems with adverse outcome. Many of these factors have been found to be associated with post-operative mortality and morbidity but lack the sensitivity and specificity required to be widely used in assessing the risk faced by an individual patient undergoing surgery.