Providence OR Surgery Program

SURGICAL RISK STRATIFICATION I III IV LOW RISK HIGHER RISK HIGHEST RISK EP ENT Orthopedic General Surgery Emergency Surgery TEE, cardioversion Nasal/Facial fracture Tendon/Ligament/Soft Tissue procedure Complex Breast-Flap Major trauma Ophthalmology Ear procedures Arthroscopy-shoulder/knee/hip Bariatric surgery General Surgery Cataract surgery MOHS Distal long bone fracture: In patient laparoscopic procedures Whipple/Pancreatectomy GI Simple neck dissection (Radius/Ulna/Tibia/Fibula) Severe Sepsis HIPEC Surgery/Major Oncologic Parotidectomy Foot/ankle procedures Perforated Viscus Gastrectomy Septoplasty Hand/wrist procedures Open intraabdominal Splenectomy Laryngoscopy Hardware removal Paraesophageal hernia repair Transplant: liver, kidney, pancreas Sinus procedures Ophthalmology Orthopedic Hepatic resection, all Thyroidectomy All non-cataract surgeries Open Shoulder arthroplasty Cardiac Surgery Tonsillectomy Plastics Knee arthroplasty TAVR Tracheostomy Abdominoplasty Hip arthroplasty All open procedures Turbinate reduction Breast reduction Pelvic fracture Thoracic EP/Cath Lab Breast reconstruction Proximal long bone fracture: Open thoracotomy Ablation Lipectomy (Humerus/ Hip/Femur) Gastrectomy MitraClip Radiology Neurosurgery Esophagectomy Other procedures MRI w/ General Anesthesia DBS Placement Pneumonectomy General Surgery Brachytherapy/Seed Implant Pituitary procedures Vascular Anorectal Kyphoplasty Radiology AAA (open) Open Inguinal Hernia CT guided biopsy/ablation TIPS Aortic Bypass Graft (AFBG) Lymph Node dissection Spine Spine Thoracic Endovascular Aortic Repair Mastectomy Anterior Cervical Discectomy Any laminectomy > 2 levels Neurosurgery Breast lumpectomy Posterior spine fusion ( 2 levels) Interventional Neuro Procedures Ambulatory laparoscopic procedures Urology Thoracic Skin/tissue resection Penile surgery Lobectomy/Wedge Resection Venous port placement Cystoscopy/ureteroscopy Mediastinoscopy GI/Pulmonary ESWL Thoracoscopy/VATS Bronchoscopy Orchiectomy Vascular EGD/PEG TULIP ERCP TURBT Gynecology TURP LE Ampuation, AKA/BKA D&C Vascular Angiographic procedures Hysteroscopy PD Catheter Placement/Removal AV fistula creation/revision Endometrial ablation Hemodialysis line placement Carotid endarterectomy Tubal Ligation/salpingectomy Other Peripheral Extremity Bypass Graft LEEP Urology Laparascopic Procedures* Cystectomy *excludes lap hysterectomy-see category III Pain Pump Implant Nephrectomy Vaginal hysterectomy Prostatectomy Sling/A&P Repair ENT Vulvar procedures Head and neck cancer procedures Maxillofacial Gynecology Dental extraction Hysterectomy: ALL abdominal Mandibular procedures Myomectomy Maxillary procedures Open gynecologic surgeries Neurosurgery Burr holes Distal extremity procedures DBS battery/lead change procedure V-P shunt Version history: published to Teams 07/08/2022 Neurostimulator Implant, aka spinal cord stimulator SURGICAL RISK GRID Surgical Risk Categories are based on potential for tissue trauma, fluid shifts, blood loss, hemodynamic change, time under anesthesia, risk of end organ compromise, and other perioperative complications. II INTERMEDIATE RISK Screening/diagnostic EGD, colonoscopy Endovascular AAA Repair Anuerysm repair

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