Pre-operative assessment
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Perioperative risk of death
Anesthesia Type of procedure or surgery Patient age Emergency procedure Pulmonary factors Cardiac factors
Scoring systems for perioperative risk
General factors
Cardiac Risk Stratification for Noncardiac Surgical Procedures
High (Reported cardiac risk often greater than 5%)
- Emergent major operations, particularly in the elderly
- Aortic and other major vascular surgery
- Peripheral vascular surgery
- Anticipated prolonged surgical procedures associated with large fluid shifts and/or blood loss
Intermediate (Reported cardiac risk generally less than 5%)
- Carotid endarterectomy
- Head and neck surgery
- Intraperitoneal and intrathoracic surgery
- Orthopedic surgery
- Prostate surgery
Low (Reported cardiac risk generally less than 1%)
- Endoscopic procedures
- Superficial procedure
- Cataract surgery
- Breast surgery
Estimated Energy Requirements for Various Activities
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Stepwise approach to preoperative cardiac assessment
Sources
http://www.askdrwiki.com/mediawiki/index.php?title=Preoperative_Clearance
References
- Eagle, K. A. et al. Circulation 2002;105:1257-1267
- Hlatky MA, Boineau RE, Higginbotham MB, et al. A brief self-administered questionnaire to determine functional capacity (the Duke Activity Status Index). Am J Cardiol. 1989; 64: 651–4