General Health
Perioperative risk assessment
Perioperative risk in orthopaedic surgery is described with a physical status class for overall fitness and a weighted comorbidity index for longer-term survival, which answer different questions.
What you are actually deciding
ASA describes fitness for anaesthesia today; the Charlson index estimates survival over years. Use ASA for perioperative planning and Charlson when the question is whether a patient will live long enough to benefit from a durable reconstruction. The Elixhauser score, with van Walraven weights, was built to predict in-hospital death from diagnosis codes, so it suits adjusting for case mix in registry and database work more than counselling one patient.
Patient-reported outcome measure1
Clinical calculator3
- Caprini Calculator37 itemsCaprini Risk Assessment Model for venous thromboembolismThe Caprini Risk Assessment Model estimates the risk of venous thromboembolism in a surgical patient by adding risk factors weighted 1, 2, 3 or 5 points — with elective lower limb arthroplasty, a hip, pelvis or leg fracture, stroke and acute spinal cord injury each worth 5 — to give a total that hospital protocols then map to a prophylaxis level.
- CCI Calculator17 itemsCharlson Comorbidity IndexThe Charlson Comorbidity Index is a weighted checklist of 16 comorbid conditions that produces a comorbidity score of 0 to 33, to which up to 4 points are added for age, and which estimates 10-year survival at roughly 98% for a total of 0, 90% for 2, 53% for 4 and 21% for 5.
- Elixhauser Calculator21 itemsElixhauser Comorbidity Score (van Walraven weights)The Elixhauser comorbidity score applies the van Walraven point weights to 30 comorbidities, giving each a whole-number weight from −7 to +12 so that their sum predicts in-hospital death from hospital diagnosis codes — and in one large national inpatient dataset it discriminated slightly better than the Charlson index.