Preoperative patient assessment: Identifying patients at high risk

•A small subgroup of high-risk patients accounts for a very high percentage of perioperative mortality.•Early preoperative risk assessment is recommended for the identification of high-risk patients•Individualizing risk assessment during all stages of the perioperative pathway decreases morbidity and mortality in the high-risk population.

Postoperative mortality remains alarmingly high with a mortality rate ranging between 0.4% and 4%. A small subgroup of multimorbid and/or elderly patients undergoing different surgical procedures naturally confers the highest risk of complications and perioperative death. Therefore, preoperative assessment should identify these high-risk patients and stratify them to individualized monitoring and treatment throughout all phases of perioperative care. A “tailored” perioperative approach might help further reduce perioperative morbidity and mortality.This article aims to elucidate individual morbidity-specific risks. It further suggests approaches to detect patients at the risk of perioperative complications.