kirurgerisk

Kirurgerisk is a term used to describe the likelihood of adverse outcomes related to a surgical procedure. In Norwegian medical usage, kirurgerisk risiko encompasses the probability of complications, prolonged recovery, or death following surgery. The concept is central to preoperative evaluation, patient counseling, and planning of perioperative care.

Risk assessment in surgery considers both patient-related and procedure-related factors. Patient-related factors include age, sex, comorbidities (such as cardiovascular disease, diabetes, chronic lung or kidney disease), functional status, frailty, nutrition, body weight, and use of medications like anticoagulants or antiplatelets. Procedure-related factors include the urgency of the operation (elective versus emergency), the invasiveness and complexity of the procedure, expected blood loss, and duration of anesthesia. Together these factors influence the overall kirurgerisk level.

Several tools are used to estimate surgical risk, including the ASA physical status classification, POSSUM and P-POSSUM, EuroSCORE II, and various comorbidity indices. These instruments provide probabilistic risk estimates that support clinical judgment rather than definitive predictions. They are intended to inform discussions with patients, guide shared decision-making, and aid in planning perioperative care.

Applications of kirurgerisk assessment include informing informed consent, determining the level of monitoring and postoperative support needed, and identifying opportunities for risk reduction. Risk reduction strategies encompass preoperative optimization or prehabilitation (such as physical conditioning, smoking cessation, nutritional support, and glycemic control), medication reconciliation, and tailored perioperative management.

Limitations exist, as risk estimates are probabilistic and cannot predict individual outcomes with certainty. Risk assessment is one component of a holistic approach to improving surgical safety and outcomes.