Surgeons’ subjective evaluations before surgery can significantly predict postoperative complications.

• 10.1% of patients had grade III complications in 2023; this increased to 12.3% in 2024.
• Surgeons’ preoperative assessment of general condition (q4) is the strongest predictor of severe complications (odds ratio 1.35 per 10-point increase).

Surgeons should consider their own insights along with traditional metrics to better stratify patient risk.

• The predictive model, including age and emergency status, showed solid performance (AUC 0.777 in 2023, 0.774 in 2024).