American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

ACS NSQIP® Surgical Risk Calculator

Guests: Clifford Y. Ko, MD,  FACS, a colorectal surgeon who is professor of surgery at University of California, Los Angeles (UCLA) and director of UCLA’s Center for Surgical Outcomes and Quality and Director of the Division of Research and Optimal Patient Care at the American College of Surgeons, and Karl Bilimoria, MD, FACS, a surgical oncologist in the Department of Surgery and Director of the Surgical Outcomes and Quality Improvement Center at the Feinberg School of Medicine at Northwestern University, Chicago, and an American College of Surgeons faculty scholar.

Listen to this episode.

In an effort to help both surgeons and patients understand the risk of a given operation, surgeons have researched and developed the first-of-its-kind comprehensive surgical risk calculator to help foster dialogue between surgeons and patients about surgical risks and create the possibility of a higher level of informed consent. The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) Surgical Risk Calculator is a tool that provides a better understanding of a particular patient’s risks before heading into the operating room.

In this episode of The Recovery Room, host Dr. Rick Greene speaks with two surgeons who helped develop this tool: Clifford Y. Ko, MD, FACS, and Karl Bilimoria, MD, FACS. Drs. Ko and Bilimoria share their thoughts on the usefulness of this tool and how it can best serve both the patient and the surgeon. Both surgeons and their colleagues used highly detailed and accurate ACS NSQIP data collected from nearly 400 hospitals and 1.4 million patients to develop the universal surgical risk calculator that covers more than 1,500 unique surgical procedures across multiple specialties. The authors leveraged the highly accurate outcomes data collected by ACS NSQIP to create the Surgical Risk Calculator.

“This [tool] should be something that both the patient and the doctor will look at and will hopefully look at it together, and it will enhance the discussion between the patient and the provider,” said Dr. Ko.

The risk calculator uses 21 risk factors that are taken into account when assessing a patient’s risk prior to an operation. Further, there is an option for the surgeon to adjust certain aspects that are more subjective and are not able to be measured simply by numbers.

“We knew that these 21 factors certainly accounted for the bulk of the risk, but certainly sometimes…there are things about the patient that we see that may not be incorporated into the 21 variables,” said Dr. Bilimoria.

Some of the primary benefits of the risk calculator discussed in the episode are that it enhances communication between the patient and surgeon and it allows for the possibility to provide unique information for each individual patient.


Dr. Ko is a colorectal surgeon on the faculty of the UCLA School of Medicine in Los Angeles, California and Director of the Division of Research and Optimal Patient Care at the American College of Surgeons. His scientific research interests include studying quality of care, quality of life, and outcomes in cancer surgery.

Dr. Bilimoria is a surgical oncologist and faculty member in the Department of Surgery and Director of the Surgical Outcomes and Quality Improvement Center at the Feinberg School of Medicine at Northwestern University in Chicago, IL. He has interests in breast cancer, skin cancer, melanoma, sarcomas, and soft tissue tumors.