ArticleUpdates in surgery2025
Use of risk assessment tools in emergency general surgery: a cross-sectional survey of surgeons and trainees.
Article in Updates in surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The applicability of risk assessment tools (RATs) for preoperative risk assessment (PRA) in Emergency General Surgery (EGS) is unclear. Limited knowledge of surgeons' approach to risk assessment is available. We investigated how Canadian surgeons approach PRA for EGS and their awareness of available RATs. Canadian Association of General Surgeons members were invited to complete an online cross-sectional survey. Descriptive statistics were reported. Of 278 respondents, 70% were attending surgeons (44% had 5-10 years in practice, 43% > 10 years), 5% fellows, and 25% residents. Most worked in medium-/large-volume centers (89%) and teaching hospitals (77%). During preoperative risk assessment, 2/3 of respondents reported applying clinical experience/instinct and referring to literature, while 55% used RATs. The best-known and used tools were the ACS-NSQIP calculator (68% and 59%) and the Emergency Surgery Acuity Score (ESAS, 66% and 47%, respectively). Surgeons were divided regarding the accuracy of RAT estimates, with 47% considering them generally accurate and 49% inaccurate. Trainees reported greater interest in major morbidity risk (86% vs. 65%) and probability of supported discharge (45% vs. 29%) than surgeons. Among participants not using RATs, 41% indicated they are scarcely accessible in the EGS context, while 33% found them cumbersome and time-consuming. RATs are underused in favor of personal judgment. The use of RATs may facilitate decision-making in elderly/complex patients and help reduce variability in practice, particularly for trainees and less-experienced surgeons. A greater effort in education is needed to spread the culture of RATs for PRA.
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Registered trials
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