Development and validation of the Surgical Outcome Risk Tool (SORT)

Development and validation of the Surgical Outcome Risk Tool (SORT)

A variety of methods are available for clinicians to help predict risk of adverse outcomes (including death) after surgery, including assessments of functional capacity (e.g. cardiopulmonary exercise testing), and risk stratification tools such as the P-POSSUM, the Surgical Risk Scale, and the American College of Surgeons National Surgical Quality Improvement Program surgical risk calculator. In 2013 a qualitative systematic review of risk stratification tools for predicting morbidity and mortality was published. The P-POSSUM and Surgical Risk Scale were found to be the most reliable risk stratification tools based on published data, but both were noted to have limitations.

In response to the "Knowing the Risk" recommendations, data from 16,788 patients included in that study were used to develop and internally validate the Surgical Outcome Risk Tool (SORT). It allows rapid and simple data entry of six preoperative variables, and provides a percentage mortality risk estimate for patients who are undergoing non-cardiac, non-neurological inpatient surgery. The scientific methods used to develop the SORT are detailed in a manuscript published by the British Journal of Surgery in 2014. At the time of publication, this work represented the largest analysis of risk prediction tools in a UK cohort of patients undergoing inpatient surgery in multiple surgical specialties.

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