Perioperative respiratory assessment

ARISCAT CalculatorPostoperative Pulmonary Risk

Calculate the original seven-variable ARISCAT score for postoperative pulmonary-complication risk stratification, with transparent point assignments and clinically bounded interpretation.

Seven original variablesNo patient data uploadedNot surgical clearance

Educational clinical decision support for adults. ARISCAT is a risk-stratification model, not a diagnosis or a substitute for anesthesiology, surgical, or perioperative evaluation. Do not use a score alone to delay, clear, cancel, or prescribe for surgery.

Original seven-variable score

Enter preoperative factors

Use the patient’s actual preoperative values and the planned procedure. This tool does not infer missing data or adjust for other comorbidities.

Risk result

Complete all seven inputs

The tool will show the original ARISCAT total, risk band, and every point assignment. It does not create a new combined risk model or issue a surgical-clearance recommendation.

Score construction

Every ARISCAT point, shown

Age

≤50: 0 · 51–80: 3 · >80: 16

Resting preoperative SpO₂

≥96%: 0 · 91–95%: 8 · ≤90%: 24

Respiratory infection in past month

No: 0 · Yes: 17

Hemoglobin

>10 g/dL: 0 · ≤10 g/dL: 11

Incision

Other: 0 · Upper abdominal: 15 · Intrathoracic: 24

Expected duration

<2 h: 0 · 2–3 h: 16 · >3 h: 23

Emergency procedure

No: 0 · Yes: 8

How to use the result safely

Use the exact model. Do not add smoking, COPD, BMI, OSA, frailty, or spirometry to the ARISCAT total; those factors may be clinically important but are not ARISCAT point variables.

Treat a high score as a prompt for a team discussion. Confirm the planned procedure and modifiable contributors, assess the patient’s full cardiopulmonary context, and use local perioperative pathways.

Keep observed cohort incidence in context. The model’s low, intermediate, and high bands are not calibrated individual predictions in every hospital, procedure type, or patient population.

Read the preoperative pulmonary-risk guide

Evidence base

Sources and limitations

The original cohort identified age, low oxygen saturation, recent respiratory infection, anemia, upper-abdominal or intrathoracic surgery, duration of at least two hours, and emergency surgery as independent PPC predictors. A recent systematic review supports moderate overall discrimination for ARISCAT but reinforces the need to avoid overconfidence in any single perioperative risk score.

Canet et al. 2010 — ARISCAT derivation and validationOriginal population-based surgical cohort and seven-variable model.Prediction models for postoperative pulmonary complications: 2025 systematic reviewFinds moderate pooled discrimination for ARISCAT and cautions that many models have high risk of bias.Comprehensive strategies for preoperative pulmonary evaluation and managementCurrent review of PPC risk assessment and perioperative pulmonary evaluation.Perioperative interventions to prevent PPCs — systematic review and meta-analysisEvidence synthesis for perioperative interventions; use alongside local practice, not as an automated treatment protocol.

Build the complete preoperative respiratory picture

Pair ARISCAT with careful history, functional status, clinically indicated testing, medication review, and the operative/anesthetic plan. PulmTools will add a dedicated STOP-Bang perioperative OSA tool next; until then, this guide keeps risk screening distinct from diagnosis and management.