About the ACS Risk Calculator

The goal of the ACS NSQIP risk calculator is to provide accurate, patient-specific risk information to guide both surgical decision-making and informed consent. The risk calculator uses 20 patient predictors (e.g., age, ASA class, BMI, HTN) and the planned procedure (CPT code) to predict the chance that patients will have any of 19 different outcomes within 30-days following surgery. The outcomes include:

  • Serious complication (cardiac arrest, myocardial infarction, pneumonia, progressive renal insufficiency, acute renal failure, PE, DVT, return to the operating room, deep incisional SSI, organ space SSI, systemic sepsis, unplanned intubation, UTI, wound disruption)
  • Any complication (superficial incisional SSI, deep incisional SSI, organ space SSI, wound disruption, pneumonia, unplanned intubation, PE, ventilator > 48 hours, progressive renal insufficiency, acute renal failure, UTI, stroke, cardiac arrest, myocardial infarction, DVT, return to the operating room, systemic sepsis)
  • Pneumonia
  • Cardiac Complication (cardiac arrest or MI)
  • Surgical Site Infection (SSI)
  • Urinary Tract Infection (UTI)
  • Venous Thromboembolism (VTE)
  • Renal Failure (progressive renal insufficiency or acute renal failure)
  • Colon Ileus (Conditionally displayed based on the selected Procedure)
  • Colon Anastomotic Leak (Conditionally displayed based on the selected Procedure)
  • Readmission
  • Return to OR
  • Death
  • Discharge to Nursing or Rehab Facility
  • Systemic Sepsis occurrences include sepsis or systemic shock
  • Predicted Length of Hospital Stay
  • T Vascular LEO Wound
  • T Pancreatectomy Delayed Gastric
  • T Proctectomy Ileus

The risk calculator was built using data collected from over 5.0 million operations from 874 hospitals participating in ACS NSQIP from 2016-20. Entering the most complete and accurate patient information will provide the most precise risk information. However, the estimates can still be calculated if some of the patient information is unknown. Detailed information regarding ACS NSQIP methodology and risk calculator modeling can be found here:




The risk calculator has been prominently mentioned in the news media. Links to the articles can be found below:

  • Data - Based Risk Calculators Becoming More Common – And More Popular

    JAMA, August 19, 2009

    http://jama.jamanetwork.com/article.aspx?articleid=184420

    “Previously, risk assessment was educated guesswork. Now the surgeon can enter preoperative risk variables about the patient and then receive a customized report that outlines the risk of mortality and specific morbidities, like surgical site infection.”

  • New Ways to Calculate to the Risks of Surgery

    Wall Street Journal, February 2, 2010

    “The last time she had surgery—on her hip, nine years ago—no one discussed risks with her. While hearing about the risks of complications and infections was ‘a little overwhelming,’ she says, "I want to know everything that might happen."

  • ACS NSQIP Risk Calculator Featured on Grey’s Anatomy TV Show

    ABC, May 6, 2010 (Episode 621)

    When faced with a high-risk case, the doctors on the show ask, “What are the risks according to the Preoperative Risk Calculator?”

  • Online Calculator Predicts Risk of Surgical Complications

    Yahoo! Health, August 20, 2013

    “The American College of Surgeons (ACS) has unveiled a new surgical risk calculator. This online tool allows anyone with a computer and an Internet connection to punch specific information into a Web page to find out potential outcomes before ever going under the knife.”

  • Online calculator assesses individual patient surgical risks

    FierceHealthIT, August 19, 2013

    http://www.fiercehealthit.com/story/online-calculator-assesses-individual-patient-surgical-risks/2013-08-19?utm_source=rss&utm_medium=rss

    “A new tool developed by the American College of Surgeons enables physicians and the public to more accurately assess the risk involved with 1,500 surgical procedures. A study describing how the Surgical Risk Calculator was developed is available online at the Journal of the American College of Surgeons.”

  • Surgery Risk Calculator Predicts Complications

    HealthLeaders, August 24, 2013

    http://www.healthleadersmedia.com/content/PHY-295558/Surgery-Risk-Calculator-Predicts-Complications

    “For the first time, surgeons have a sophisticated risk calculator said to accurately predict the chance of death or a number of other bad outcomes, such asrenal failure or infection, for nearly any surgical procedure done in a U.S. hospital.

    ‘The old way we were assessing risk was very simple and it only applied to three or four operations, and only gave three outcomes,’ says Karl Bilimoria, MD, director of Surgical Outcomes and Quality Improvement Center at Northwestern University who developed the calculator with the American College of Surgeons.”

  • New calculator tool quantifies a patient’s risk for surgery complications

    MedCity News, August 23, 2013

    http://medcitynews.com/2013/08/new-calculator-tool-quantifies-a-patients-risk-for-surgery-complications/?amp;co=f000000009816s-1158206718

    “As part of its National Surgical Quality Improvement Program, the American College of Surgeons has developed a surgical risk calculator it says is an important decision-support tool for doctors and patients to truly collaborate on making care decisions. The online calculator asks for 21 pieces of information about a patient, including age, gender, comorbidities and the procedure he’s thinking of having done.”

  • Calculator Estimates Individual Surgical Complications Risk

    Science Business, August 14, 2013

    http://sciencebusiness.technewslit.com/?p=15110&utm_source=rss&utm_medium=rss&utm_campaign=calculator-estimates-individual-surgical-complications-risk&co=f000000009816s-1158206718

    “Medical researchers with American College of Surgeons devised an online system that calculates an individual’s risk of developing complications for nearly all kinds of surgery. The team led by Karl Bilimoria, director of the Surgical Outcomes and Quality Improvement Center at Northwestern University in Chicago, with colleagues from the UCLA medical center and VA Greater Los Angeles Healthcare System, published a preliminary online report of its Surgical Risk Calculator last month in the Journal of the American College of Surgeons (paid subscription required), with the final paper scheduled to appear in thatjournal later this year.”

  • American College of Surgeons constructs surgical risk calculator

    Cardiology Today, August 14, 2013

    http://www.healio.com/orthopedics/business-of-orthopedics/news/online/%7B5615b65f-f014-41d3-89ca-6e174913c9d2%7D/american-college-of-surgeons-constructs-surgical-risk-calculator

    “Researchers from the American College of Surgeons have created a web-based Surgical Risk Calculator using information gathered from 400 different hospitals and 1.4 million patients across 1,500 surgical procedures in multiple specialties.”

  • Surgical Risk Calculator improves quality of care, shared decision making and patient-centered informed consent

    Medical News Today

    http://www.medicalnewstoday.com/releases/264846.php?&co=f000000009816s-1158206718

    “The new American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) Surgical Risk Calculator is a revolutionary new tool that quickly and easily estimates patient- specific postoperative complication risks for almost all operations, according to research findings appearing online in the Journal of the American College of Surgeons. The study will be published in a print edition of the Journal later this year.”

  • Know Your Chances: Online Calculator Predicts Risk of Surgical Complications

    Healthline News, August 19, 2013

    http://www.healthline.com/health-news/tech-online-surgical-risk-calculator-helps-you-plan-ahead-081913

    “Making difficult decisions about whether to have a potentially risky surgery just got easier for doctors and patients. The American College of Surgeons (ACS) has unveiled a new surgical risk calculator. This online tool allows anyonewith a computer and an Internet connection to punch specific information into a Web page to find out potential outcomes before ever going under the knife.”

  • New ACS NSQIP Surgical Risk Calculator Offers Personalized Estimates of Surgical Complications

    Surgery News, September 6, 2013

    http://www.acssurgerynews.com/single-view/new-acs-nsqip-surgical-risk-calculator-offers-personalized-estimates-of-surgical-complications/db28ccaa502f8568b9cc6e1d2c39aa51.html

    “Surgeons and patients have long sought an accurate decision-support tool to estimate patients’ risks of complications after surgical procedures. This process is essential for patient-centered care, shared decision making with patients, and true informed consent."

  • 5 questions to ask before surgery

    CNN.com, September 25, 2013

    http://www.cnn.com/2013/09/25/health/surgery-questions/index.html

    “In August, Bilimoria and researchers at the American College of Surgeons released an online tool that allows patients, in collaboration with their doctors, to estimate what their risks may be in undertaking an operation.”