ARISCAT score
Risk of postoperative pulmonary complications
Sources last checked: 2026-10-13
ARISCAT score
Risk of postoperative pulmonary complications
Derived in 59 Catalan hospitals; complication definitions were broad (including mild events). Choose the incision of the most invasive part of the procedure.
Interpretation
| < 26 — low risk | Postoperative pulmonary complications ≈ 1.6 % (validation subsample). |
|---|---|
| 26–44 — intermediate risk | Postoperative pulmonary complications ≈ 13.3 %. |
| ≥ 45 — high risk | Postoperative pulmonary complications ≈ 42.1 %. |
What is the ARISCAT score?
ARISCAT estimates the risk of postoperative pulmonary complications from seven preoperative and procedural factors. Canet and colleagues derived it in 2010 in a population-based cohort of 2 464 surgical patients from 59 hospitals in Catalonia, Spain, and it was externally validated across Europe in the PERISCOPE study.
When to use it
- Preoperative assessment of adults scheduled for surgery under general, neuraxial or regional anaesthesia
- Identifying patients at higher risk of postoperative pulmonary complications
- Structured documentation of postoperative pulmonary risk
When not to use it
- Procedures under local anaesthesia or sedation only, which were not represented
- Children and obstetric patients
- As the sole basis for cancelling surgery
How it is calculated
| Criterion | Points |
|---|---|
| Age | |
| ≤ 50 years | 0 |
| 51–80 years | 3 |
| > 80 years | 16 |
| Preoperative SpO₂ (room air) | |
| ≥ 96 % | 0 |
| 91–95 % | 8 |
| ≤ 90 % | 24 |
| Respiratory infection in the last month | +17 |
| Preoperative anaemia (Hb ≤ 10 g/dL, ≤ 100 g/L) | +11 |
| Surgical incision | |
| Peripheral | 0 |
| Upper abdominal | 15 |
| Intrathoracic | 24 |
| Duration of surgery | |
| < 2 h | 0 |
| 2–3 h | 16 |
| > 3 h | 23 |
| Emergency procedure | +8 |
Clinical pearls and limitations
- Derived in 59 Catalan hospitals; complication definitions were broad (including mild events). Choose the incision of the most invasive part of the procedure.
- SpO₂ and recent respiratory infection carry the most points apart from incision site; the score uses SpO₂ measured on room air at rest.
- Upper abdominal and intrathoracic incisions weigh heavily; laparoscopic upper abdominal surgery is usually scored by the site of the incision.
- The complication definition was broad (including bronchospasm, atelectasis, pleural effusion), so absolute rates are higher than for severe events alone.
- Several items (duration, emergency) are procedural and only approximately known before surgery.
Frequently asked questions
What ARISCAT score is high risk?
45 or more. In the validation subsample about 42 % of these patients developed a postoperative pulmonary complication.
Which anaemia threshold does ARISCAT use?
Haemoglobin of 10 g/dL (100 g/L) or less before surgery.
Is ARISCAT validated outside Spain?
Yes. The PERISCOPE study (Mazo 2014) validated it prospectively in European centres, with reasonable discrimination.
Evidence and guidelines
- Primary source: Canet J et al. Prediction of postoperative pulmonary complications in a population-based surgical cohort (ARISCAT). Anesthesiology 2010;113(6):1338-1350. Points and bands from the paper as reproduced in open-access tables (e.g. PMC9333546); band rates from the validation subsample.
- Mazo V et al. Prospective external validation of a predictive score for postoperative pulmonary complications (PERISCOPE). Anesthesiology 2014;121:219-231.
Have a follow-up question?
Medelix answers clinical questions from current guidelines and studies — every statement with its source.
Ask Medelix about the ARISCAT scoreRelated calculators
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