SORT — Surgical Outcome Risk Tool
UK-derived tool predicting 30-day postoperative mortality for in-hospital non-cardiac surgery. Validated in 22,000 patients. Endorsed by RCS England.
Score interpretation
SORT low risk: predicted 30-day mortality < 1%.
→ Standard perioperative care. Day-case or short-stay pathway appropriate. Routine anaesthetic review. Patient information and consent with documented risk discussion.
SORT moderate risk: predicted 30-day mortality 1–5%.
→ Senior anaesthetist review. Level 1 (ward) or Level 2 (HDU) postoperative care planning. Cardiopulmonary exercise testing (CPET) or echocardiogram if cardiac risk concerns. Optimise comorbidities pre-operatively. Formal consent with documented risk figures.
SORT high risk: predicted 30-day mortality > 5%. Level 2/3 care planning mandatory.
→ Multidisciplinary perioperative team discussion (surgeon, anaesthetist, intensivist). CPET assessment. Level 3 (ICU) bed booking pre-operatively. Consider non-operative management if risk-benefit unfavourable. Prehabilitation if time allows. MUST screen + nutritional optimisation. Goals of care discussion — advance care planning.
Interpretation bands for the SORT. Apply clinical judgement and local guidance.
References
- Protopapa KL et al. Development and validation of the Surgical Outcome Risk Tool (SORT). Br J Surg. 2014.
- Royal College of Surgeons of England. The High Risk Surgical Patient. 2018.
Related
Curated clinical cross-links plus same-class fallbacks.
- POSSUM Score for Surgical Morbidity and Mortality · Perioperative Risk
- SORT (Surgical Outcome Risk Tool) · Perioperative Risk
- Revised Cardiac Risk Index (RCRI / Lee Index) · Perioperative Risk
- ASA Physical Status Classification · Perioperative Risk
- Gupta Perioperative Risk for MI or Cardiac Arrest (MICA) · Perioperative Risk
- Cardiovascular Risk in Orthotopic Liver Transplantation (CAR-OLT) Score · Perioperative Risk
- Tranexamic Acid (ICU/Trauma/Surgical) · Antifibrinolytic
- Ephedrine Hydrochloride 0.5% Nasal Drops · Nasal decongestant — sympathomimetic (perioperative / ENT use)
- Cefuroxime · Second-Generation Cephalosporin — Respiratory / Surgical Prophylaxis
- Sodium hyaluronate · Ocular lubricant (hyaluronic acid)
- Cefazolin · First-Generation Cephalosporin (Surgical Prophylaxis)
- Palivizumab · RSV Prophylaxis — Monthly Monoclonal Antibody (High-Risk Infants)
- Major Trauma — Primary Survey (ATLS) · ATLS 10th Edition; JRCALC; NICE NG39
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Burns — TBSA Estimation & Fluid Resuscitation · British Burn Association; EMSB; RCEM 2024
- Lower Gastrointestinal Bleed · NICE; BSG; ACPGBI — Commissioning Guide
- Acute Pancreatitis · NICE; IAP/APA; ACPGBI — CG104
- Hypertrophic Pyloric Stenosis · BAPS / RCPCH
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.