Project description: Worldwide, an estimated 234 million surgical procedures are performed each year. While most patients proceed to an uneventful recovery, 15% of procedures are complicated by adverse events (AEs), including strokes, heart attacks, blood clots and wound infections. These directly result in an overall 4% risk of death following surgery worldwide. Aside from the impact on the patient, AEs increase health care costs by up to 172%. Accurate risk prediction is thus pivotal for both the patient and society. With this project, we seek to assess the role of genetics and epigenetics in surgical AEs. Furthermore, we will evaluate whether artificial intelligence can assist in both surgical risk prediction as well as the identification of genetic and epigenetic factors of relevance to surgical outcomes. To do this, we have established an international collaboration with Harvard University and the University of Michigan with the hope of collectively identifying novel factors that can reduce surgical AEs.