Man against the machine - Differences in surgical risk evaluation. A cohort prospective study

Amir Hacohen Solovitz, Shimon Ivry, Ohad Ronen

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: The aim of this study was to compare the assessment provided by the ACS Surgical Risk Calculator with the assessments provided by senior and resident anesthesiologists. Methods: The study is prospective and controlled. Before the surgical procedure a resident anesthesiologist collected data needed to perform pre-operative assessment. Then, based on this data, a risk assessment was carried out by resident and senior anesthesiologists and by the online ACS Surgical Risk Calculator. Then the three evaluations were compared. Demographic and clinical data were gathered to determine risk factors and complication rates. Results: One hundred patients who were scheduled for a surgical procedure were recruited for the study. A difference was found among the different estimations. In most parameters the resident anesthesiologists more resembled the ACS assessment than the senior anesthesiologists. The following differences in risk assessment were found: possible complication in the course of the surgery (4.4% ACS calculator, 1% senior anesthesiologists, 2.2% resident anesthesiologists), and for a life-threatening complication (3.6% ACS calculator, 0.5% senior anesthesiologists, 2.4% resident anesthesiologists). In assessing death, urinary tract and surgical sites infections the seniors difference to the ACS calculator was statistically significant (p < 0.05). Seniors resembled better cardiac complications (p < 0.05) and both resident and senior anesthesiologists failed to resemble the ACS calculator in assessing return to the operating room and pneumonia (p < 0.05). Conclusions: Both senior and resident anesthesiologists failed to estimate the surgical risks based on preoperative data. Further study involving the surgeons and comparing the estimated to the actual complication rates are needed.

Original languageEnglish
Pages (from-to)252-256
Number of pages5
JournalInternational Journal of Surgery
StatePublished - Dec 2018

Bibliographical note

Publisher Copyright:
© 2018 IJS Publishing Group Ltd


Based on the above it is inferred that the ACS calculator is a decision-support tool that can and should be used by both senior and resident anesthesiologists, to assess pre-operative overall risk. Thus, the ACS should be used as an additional tool applied by the physician to get a more precise risk assessment. Moreover, the physicians can readily use the ACS assessment to help them discuss with the patient the associated risks involved in the operation during the informed consent process, since the program is visually simple to understand [6,7].

FundersFunder number
Affiliated Computer Services


    • American college of surgeons surgical risk calculator
    • Anesthesiologist
    • Complications
    • Residents
    • Surgical risk evaluation


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