The European Society of Thoracic Surgeons has recently established an institutional accreditation program to standardize and improve practice across institutions in Europe according to existing guidelines. The objective of this initiative is to implement a risk stratification assessment tool for calcualting in-hospital or 30-day cardiopulmonary mortality and morbidity rates before thoracic surgery. Although these risk scores should not be used to select patients for operation, they can help to identify those patients who need further assessment during the preoperative consultation.