Risk assessment in anaesthesia

Over 230 million major surgical procedures are undertaken worldwide each year. For the majority of patients the risks of surgery are low but complications following surgery are an important cause of death. Approximately 10% of patients undergoing surgery in the UK are identified as being at high risk of complications. This ‘high-risk’ group of patients accounts for approximately 80% of all postoperative deaths.Clinical risk assessment is fundamental to the management of patients undergoing surgery and anaesthesia. Accurate risk stratification allows an individual patient's perioperative care pathway to be modified with the aim of reducing morbidity and mortality. A growing evidence base supports the utility of cardiopulmonary exercise testing (CPET) to identify high-risk surgical patients. Identifying these patients can help guide anaesthetic technique, influence surgical plans and ensure appropriate use of critical care resources, all with the aim of improving patient outcomes.