A surgical risk calculator is a tool that predicts a given person’s likelihood of having an unfavorable outcome, or complication, after surgery. Typically available via online interface on a website, risk calculators allow patients and health care providers alike to assess a person’s individualized risk going into surgery. The goal is for the information gleaned from the risk calculator to better inform patients and clinicians whether or not it is safe for a patient to undergo the surgery at hand. The concept of individualized risk assessment tools like those Dr. Kim and his team of research fellows are developing is powerful — no longer does a patient or doctor need to base their surgical decision making off population estimates, but they now have access to individualized estimates. This is important because if a woman who is 5 feet 2 inches tall, 110 pounds, has never smoked, and is generally healthy is contemplating undergoing the same surgery as a woman who is 5 feet 2 inches tall, 190 pounds, is a previous smoker, and has a disease like diabetes, those two women have different risks of complications from the surgery. But a population-based estimation of risk will give those two very different patients just a single prediction of risk. Whereas an individualized risk calculator will calculate a unique risk profile for each woman, which is theoretically much more accurate.
Dr. Kim and his team just finished developing a Breast Reduction Risk Calculator, which can be found at breastreductionriskassessment.org. Using this tool, a patient contemplating breast reduction surgery can input her age, height and weight, race/ethnicity, smoking history, etc. and receive her percent likelihood of having the following complications after reduction mammoplasty, or breast reduction: surgical site infection, seroma (fluid collection), dehiscence (wound separation), reoperation, and any surgical complication. For example, a woman who is 5’5”, 150 lbs., 30 years old, Hispanic, has never smoked, does not have diabetes or labored breathing, and is not currently on steroids has a 3.12% chance of developing an infection, according to Dr. Kim’s calculator. Dr. Kim’s work is already proving instrumental in patient-physician communication and decision making, and particularly in the realm of expectation management.