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Table 4 Comparison of risk prediction scoring systems

From: Clinical review: Can we predict which patients are at risk of complications following surgery?

Risk prediction system Description Advantages Disadvantages
American Society of Anesthetists Numerical scale (1 to 5) based on severity of co-morbidities Simple, easily applied, well known Subjective, not individual or procedure specific, poor sensitivity and specificity
Charlson Comorbidity Score Additive score based on weighting of preoperative diseases Simple, better predictor than American Society of Anesthetists, good at estimating population risk Subjective, does not look at procedure, mainly used as a research tool
Revised Cardiac Risk Index Scoring system based on presence of one of six major co-morbidities and the severity of operation Simple, well validated and good for predicting cardiac risk Single-organ risk, broad categories, assessment of severity of operation is subjective
Acute Physiology and Chronic Health Evaluation 12 to 17 variables, measured over 24 hours Individualised predictor of risk of mortality and morbidity, better predictor of outcome than American Society of Anesthetists, well known Multiple variables over 24 hours of critical care, can be difficult to score before emergent surgery, not designed for use perioperatively
Simplified Acute Physiology Score 17 variables measured over 24 hours Well validated for predictive mortality Multiple variables over 24 hours of critical care, can be difficult to score before emergent surgery, not designed for use perioperatively
Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity Scoring of 12 physiological and six operative variables, which are then entered into two mathematical equations to predict mortality and morbidity Best validated and known/used scores for perioperative prediction various surgery-specific variations for specific areas May overestimate or underestimate mortality and morbidity in specific populations due to use of logarithmic regression