SUrgical Risk Preoperative Assessment Patient Individualized Risk Assessment Handout
System (SURPAS)
Find it via Control-K in active patient encounter
SURPAS is an individualized, preoperative risk
assessment system accurately predicting risk of 11,
30-day postoperative complications (mortality,
overall morbidity, unplanned readmission,
infection, UTI, pulmonary, renal, cardiac,
transfusion, VTE, stroke) from input of 7 variables
(primary operation, patient age, functional status,
ASA class, inpatient/outpatient operation,
emergency operation, surgeon specialty).
Benefit to Users
1. Increases patient engagement in their care
2. Improves the process of informed consent
3. Improves the process of shared decision
4. Increased patient satisfaction in care delivery
5. Provides patients with risk estimates handout
6. Provides surgeons with EHR documentation
7. Potential to improve patient perioperative care
8. Potential to decrease postoperative
complications
SURPAS is integrated into Epic HER at UCHealth
Facts about SURPAS
1. Covers 9 specialties (general, vascular,
orthopedics, urology, ENT, plastic, thoracic,
gynecologic, neurosurgery).
2. Modeling based upon the ACS NSQIP database
(>6 million operations from >800 hospitals).
3. Patient’s individualized risk is compared to
national average for all patients undergoing the
same operation, calculated from the ACS NSQIP
database.
Updated 07/21/2019
Results of 3 Pilot Studies at UCH
A. 10 Surgeons using SURPAS with 197 patients:
1. 93% of patients rated SURPAS as very helpful or
helpful.
2. 99% of patients said they understood their risks
very or quite well.
3. 83% of the time the surgeons said that SURPAS
was very helpful, helpful, or somewhat helpful.
4. 45% of the time the surgeons said that SURPAS
changed interaction with the patient, and this
change was beneficial 94% of the time.
B. 90 surgical patients receiving SURPAS vs. 100
receiving usual care:
1. Patients estimated time spent discussing SURPAS
risk was less than half the usual time (p<0.0001).
2. 83% of SURPAS patients were very satisfied with
risk discussion vs. 16% of usual care pts (p<0.0001).
3. 78% of SURPAS patients made more comfortable
with surgery plan vs. 19% of usual care (p<0.0001).
4. Patient anxiety was greatly or somewhat
decreased 92% of time with use of SURPAS vs. 20%
receiving usual care (p<0.0001).
C. Comparing SURPAS to the ACS NSQIP Risk Calculator
in 1,006 patients:
1. Mortality estimates were similar.
2. SURPAS overall morbidity estimates were on target
with observed morbidity (10.65%); ACS NSQIP calculator
underestimated morbidity risk (7.73%), particularly in
high risk patients.
3. SURPAS requires 7 predictor variables and is built into
Epic; ACS NSQIP calculator requires 24 predictor
variables and is accessed on the web.
Other applications of SURPAS: SURPAS can be used to
compare individual patient risk profiles for alternate
procedures, for Morbidity & mortality risk stratification.