Relevant bibliographies by topics / Preoperative medical assessment

Academic literature on the topic 'Preoperative medical assessment'

Author: Grafiati
Published: 10 December 2022
Last updated: 28 January 2023

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Journal articles on the topic "Preoperative medical assessment"

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Leuze, Maria, and Jim McKenzie. "Preoperative Assessment." AORN Journal 46, no. 6 (December 1987): 1122–34. http://dx.doi.org/10.1016/s0001-2092(07)69723-3.

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Takahashi, Jacklyn J., and Shelley C. Bever. "Preoperative Nursing Assessment." AORN Journal 50, no. 5 (November 1989): 1022–35. http://dx.doi.org/10.1016/s0001-2092(07)66973-7.

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Mendelsohn, Colin, Austin Ng, and Leonard Kritharides. "Smoking and preoperative assessment." Australian Prescriber 38, no. 2 (April 1, 2015): 39–40. http://dx.doi.org/10.18773/austprescr.2015.021.

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Rockhill, Wayne. "Preoperative Assessment and Management." AORN Journal 91, no. 1 (January 2010): 184–85. http://dx.doi.org/10.1016/j.aorn.2009.10.003.

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Auvergne, Lauriane, Rocio Quinonez, Michael W. Roberts, J. Nicole Drawbridge, Michael Cowherd, and Michael J. Steiner. "Preoperative Assessment for Children Requiring Dental Treatment Under General Anesthesia." Clinical Pediatrics 50, no. 11 (June 2, 2011): 1018–23. http://dx.doi.org/10.1177/0009922811410873.

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Objective. This study aimed to describe children <6 years requiring general anesthesia for dental treatment and factors associated with a change in medical management prior to surgery. Study design. This case series reviewed the past medical history and preoperative assessment of patients referred for dental preoperative evaluations at a single institution (2005-2008). A “deflection” was defined as a recommendation to change preoperative or operative care based on the preoperative assessment. The sample was analyzed using descriptive, bivariate, and multivariate analyses. Results. Of 648 subjects (aged 9 months to 6 years, mean 3.9 years), 63% had a past medical history abnormality and 38% had previous surgery. In total, 14% were deflected, most commonly because of the addition of infective endocarditis prophylaxis (29%). A history of coagulation disorder had the strongest association with deflection ( P < .0001, odds ratio = 10.0, 95% confidence interval = 4.6-22.1), followed by cardiac anomalies. Conclusion. Preoperative assessments for pediatric dental treatment frequently identify medical problems resulting in treatment plan alterations.
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Cassidy, Janet, and Rex A. Marley. "Preoperative assessment of the ambulatory patient." Journal of PeriAnesthesia Nursing 11, no. 5 (October 1996): 334–43. http://dx.doi.org/10.1016/s1089-9472(96)90091-x.

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Engel, Cindy, and Kristin Styer. "Establishing a Preoperative Skin Assessment Practice." Journal of PeriAnesthesia Nursing 24, no. 3 (June 2009): e19. http://dx.doi.org/10.1016/j.jopan.2009.05.078.

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Siragusa, Lanette, Lorena Thiessen, Dean Grabowski, and R. Shawn Young. "Building a Better Preoperative Assessment Clinic." Journal of PeriAnesthesia Nursing 26, no. 4 (August 2011): 252–61. http://dx.doi.org/10.1016/j.jopan.2011.05.008.

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Schneider, Wolfgang, and Karl Knahr. "Poor Agreement Between Prospective and Retrospective Assessment of Hallux Surgery Using the AOFAS Hallux Scale." Foot & Ankle International 26, no. 12 (December 2005): 1062–66. http://dx.doi.org/10.1177/107110070502601211.

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Background: Retrospective assessment of preoperative status is common in nonprospective study designs. The aim of this study was to test the hypothesis that prospective and retrospective evaluations of the preoperative patient condition in hallux surgery gives equal results and therefore can be used interchangeably. Methods: One hundred and fifty-nine consecutive feet with hallux surgery were analyzed prospectively. Parallel to routine evaluation of the preoperative status, the AOFAS Hallux Scale was recorded prospectively. Two years after surgery, the medical records were re-evaluated for retrospective reconstruction of the AOFAS score. Simultaneously all patients were asked to assess their preoperative status retrospectively. Results: Using the medical charts for retrospective assessments, the preoperative status was estimated too low compared to prospective evaluation. This effect was even more pronounced with the patients' own retrospective assessment of their preoperative status. Linear regression coefficient for prospective and retrospective data showed moderate correlation with r = 0.59 for the AOFAS Score using the medical charts and poor correlation of r = 0.24 using the patients' own retrospective assessments. Spearman's rank correlation index was p = 0.57 and p = 0.23, respectively. The coefficient of repeatability according to Bland and Altman was 25.7 and 48.7 points, respectively, for the AOFAS score. The difference between the mean values of prospective and retrospective assessment was 5.6 (13.0) points. This means that a retrospectively evaluated AOFAS Score may be 31.3 points below or 20.1 points above prospective assessments (61.6 points below or 35.7 points above compared to the patients' own retrospective self-assessments). Agreement between individual items using Kappa statistics showed poor results except for metatarsophalangeal joint motion. Conclusions: Prospectively and retrospectively evaluated AOFAS scores cannot be used interchangeably for clinical outcome evaluations. Retrospective scoring gives worse results even when evaluated using conscientiously recorded medical charts and therefore leads to overestimation of the effect of surgery. These data support prospective study designs to ensure the best outcome analysis for clinical evaluation of hallux surgery.
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Wiertel-Krawczuk, Agnieszka, and Juliusz Huber. "Iatrogenic injury and regeneration of the facial nerve after parotid gland tumour surgery: a pilot study with clinical and neurophysiological assessment." Journal of Medical Science 89, no. 1 (March 31, 2020): e385. http://dx.doi.org/10.20883/medical.385.

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Introduction. Benign tumour surgery of the parotid gland may cause iatrogenic injury of the facial nerve, with results of postoperative treatment depending on the type of injury. The study aimed to clarify the mechanism of facial nerve injury after benign tumour surgery of parotid gland. Materials and Methods. The effectiveness was verified preoperatively and 1, 3, 6 and 17 months postoperatively. House-Brackmann scales, electroneurography, blink reflex study and needle electromyography were performed. Pharmacological treatment (Galantamine, Cocarboxylase, Dexamethasone, Triamcinolone) and supervised physiotherapeutic procedures (Facial-Oral-Tract-Therapy, Proprioceptive neuromuscular facilitation) were applied for six months. Results. Tumour removal led to the total paralysis of the left facial nerve, IV, III and III House-Brackmann grades were ascertained at the subsequent 3rd–5th periods of observation. In postoperative studies, electroneurography results showed full functional recovery of the frontal branch and incomplete regeneration in the marginal mandibular branch. Blink reflex examination showed proper parameters of evoked potentials only during preoperative and the last observation period. Residual voluntary activity of the frontal muscle and weak voluntary activity of orbicularis oris muscle were recorded in the needle electromyography examination. Contracture of mimic muscles at rest and improvement of their voluntary activity on the left side was observed six months after surgery compared to the early period of observation. Conclusion. Consecutive studies showed the predominant axonal type of injury in the marginal mandibular branch and neuropraxia effect of the facial nerve, allowing the creation of a rehabilitation programme optimal for the functional recovery of the nerve.
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Dissertations / Theses on the topic "Preoperative medical assessment"

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Pham, Clarabelle Thuymai. "Evaluation of Services for the Preoperative Assessment and Management of High-Risk Surgical Patients." Thesis, 2019. http://hdl.handle.net/2440/120359.

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Outpatient preoperative assessment clinics, such as the physician-led high-risk clinic in a large metropolitan public hospital in South Australia, have been established to assess and manage surgical patients at high risk of morbidity and mortality due to their medical co-morbidities. To date, the design and implementation of preoperative medical assessment and management has been heterogeneous, with minimal detail on the actual services provided as part of the intervention. Further, there have been no published studies evaluating the costs and outcomes of physician-led preoperative assessment for patients with modifiable medical co-morbidities prior to elective surgery. Five distinct projects contributed to the main aims of this research: to evaluate the preoperative assessment and management services provided by the physician-led high-risk clinic, and provide recommendations for improvement using an explanatory sequential mixed methods approach. This research represents the first comprehensive evaluation of services for the preoperative assessment and management of high-risk surgical patients. Multiple regression analyses identified nine potentially modifiable medical co-morbidities to be associated with increased length of stay and postoperative complications, supporting the rationale that optimisation of poorly controlled medical co-morbidities prior to surgery could improve postoperative outcomes. The costs and effects of physician-led preoperative assessment and management were evaluated using a propensity score-based approach with retrospective and prospective data. It was found that the clinic reduced the frequency of unnecessary admissions and cancellations but significant uncertainty remained around the effect of the clinic on length of hospital stay, postoperative complications, hospital costs and post-discharge mortality. Supplemental data on a prospective cohort of patients identified preoperative health-related quality of life as a potential unmeasured confounder in the evaluation, with high-risk clinic patients reporting lower mean index scores. Semi-structured interviews with surgeons found that the factors influencing their decision to refer a patient to the high-risk clinic appear to be driven by the aim to manage the uncertainty and risk to the patient regarding surgery and it was seen as a strategy for managing difficult and complex cases. Additionally, the integration of the services provided by the clinic in this study appear to offer additional value in supporting the surgical decision-making process for the surgical team and patient beyond the clinical outcomes, such as managing the patient’s expectations regarding care and assistance after discharge from hospital. Further perspectives from patients and other medical professionals collaborating with the clinic should be explored and would provide further insight into the aspects of care that provide additional value. This evaluation provides a guide to the identification of elective surgical patients who are likely to benefit most from preoperative physician-led medical optimisation and provides clarity on the collaborative care provided by the high-risk clinic and surgical teams in managing complex patients, to inform the assessment of such clinics in Australia. Such models of care involving the management of high-risk patients are increasingly likely as the public hospital system is subjected to increasing demands from an ageing population. This research has demonstrated the need to plan for the robust evaluation of new health service initiatives, which may be facilitated through better co-ordinated planning and evaluation across Australian hospitals.
Thesis (Ph.D.) -- University of Adelaide, School of Public Health, 2019
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Ribeiro, Lídia Teresa Alves. "Positive margins prediction in breast cancer conservative surgery: assessment of a preoperative web-based nomogram." Master's thesis, 2016. https://repositorio-aberto.up.pt/handle/10216/89279.

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Ribeiro, Lídia Teresa Alves. "Positive margins prediction in breast cancer conservative surgery: assessment of a preoperative web-based nomogram." Dissertação, 2016. https://repositorio-aberto.up.pt/handle/10216/89279.

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Windsor, John Albert. "Body protein loss in preoperative patients : the assessment of its impact on physiologic function and surgical risk." 1988. http://hdl.handle.net/2292/5506.

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The nutritional assessment of patients awaiting major abdominal surgery is important. It has been shown that malnutrition is common in such patients, but is often unrecognized. Because of the widespread availability of safe forms of nutritional therapy the task of identifying patients who warrant this therapy has become more urgent. However, current techniques used for the identification of significantly malnourished surgical patients have several important limitations. It has become increasingly evident that a fresh approach to nutritional assessement is now required. Drawing on some preliminary evidence that the loss of body protein is associated with an impairment of a range of physiologic functions, this thesis asserts that in order to improve on our ability to identify preoperative patients who are at a significantly increased risk of postoperative morbidiy and mortality because of the loss of body protein, it would be necessary to assess physiologic functions that can be easily measured, are protein dependent, and clinically relevant. Therefore, the following concept was investigated: That patients lose weight in response to disease and/or nutrient deprivation and the important component of this loss is body protein. The loss of body protein results in an impairment of important physiologic functions, which is the basis of the increased surgical risk noted in malnourished patients, and which results in the increased morbidity and mortality after major surgery. In order to investigate the inter­relationships of weight loss, protein loss, impaired function and surgical risk several objective measurement techniques had to be developed in order to measure physiologic functions (respiratory function, liver function, skeletal muscle function, wound healing reaponse and psychological function). An in vivo neutron activation analysis facility was available for the direct measurement of body protein status. In addition, techniques for the clinical assessment of nutritional status, diet, and postoperative course were developed. The fundemental conclusions of these clinical studies were: [1] that the measurement of preoperative weight loss is no longer useful in identifying patients who are at an increased risk of dying following major surgery, [2] that the preoperative loss of body protein is associated with an increased postoperative morbidity and mortality, [3] that the loss of body protein is associated with an impairment of clinically relevant physiologic functions including liver, skeletal muscle and respiratory function, [4] that a proportion (20 to 25%) of body protein can be determined and must be lost before there is an impairment of some important physiologic functions, [5] that plasma transferrin and prealbumin concentrations are sensitive to the adequacy of recent food intake, and are a measure of body protein status in the elective patients studied, [6] that plasma albumin concentration, in the elective patients studied, is sensitive to the adequacy of recent food intake, but does not reflect body protein status, [7] that voluntary grip strength is a practical and sensitive measure of the extent of body protein loss, [8] that body protein loss is an important, and hitherto unrecognized risk factor for postoperative pneumonia because of its impact on respiratory function [9] that the wound healing response is sensitive to the adequacy of recent food intake but not to body protein status, and [10] that a clinical assessment of weight loss, wasting and physiologic function can be objectively validated and can identify preoperative patients at an increased risk of postoperative morbidity and mortality. There are several important implications of these studies. The future direction of nutritional assessment will be the refinement of a clinical method that incorporates an assessment of physiologic function. Further study is required to demonstrate that nutritional therapy is able to reverse the impairment of clinically relevant physiologic functions and to demonstrate that such an improvement translates into a decrease in postoperative morbidity and mortality. It may be that specific defects due to Protein loss and responsible for the impairment of function can be identified and treated with shortterm nutritional therapy. The method of clinical assessment developed in this thesis can used be used to select preoperative patients for nutritional therapy and predict the likely efficacy of such therapy.
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Books on the topic "Preoperative medical assessment"

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Medical assessment of the elderly surgical patient. Rockville, Md: Aspen Systems Corp., 1986.

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Seymour, Gwyn. Medical assessment of the elderly surgical patient. London: Croom Helm, 1985.

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J, McArthur-Rouse Fiona, and Prosser Sylvia, eds. Assessing and managing the acutely ill adult surgical patient. Oxford: Blackwell Pub., 2007.

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van Lier, Felix, and Robert Jan Stolker. Preoperative assessment and optimization. Edited by Jonathan G. Hardman. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199642045.003.0040.

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Perioperative cardiovascular complications (including myocardial ischaemia and myocardial infarction) are the predominant cause of morbidity and mortality in patients undergoing non-cardiac surgery. The pathophysiology of perioperative myocardial infarction is complex. Prolonged myocardial ischaemia due to the stress of surgery in the presence of a haemodynamically significant coronary lesion, leading to subendocardial ischaemia, and acute coronary artery occlusion after plaque rupture and thrombus formation contribute equally to these devastating events. Perioperative management aims at optimizing the patient’s condition by identification and modification of underlying cardiac risk factors and diseases. The first part of this chapter covers current knowledge on preoperative risk assessment. Current risk indices, the value of additional testing, and new preoperative cardiac risk makers are investigated. During recent decades there has been a shift from the assessment and treatment of the underlying culprit coronary lesion towards a systemic medical therapy aiming at prevention of myocardial oxygen supply–demand mismatch and coronary plaque stabilization. In the second part of this chapter, risk-reduction strategies are discussed, including β‎-blocker therapy, statins, and aspirins. A central theme in this chapter will focus on long-term cardiovascular risk reduction. Patients who undergo non-cardiac (vascular) surgery are particularly prone to long-term adverse cardiac outcomes. The goal of perioperative cardiovascular risk identification and modification should not be limited to the perioperative period, but should extend well into the postoperative period.
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Aminian, Ali. Online Preoperative Risk Assessment Tools. Edited by Tomasz Rogula, Philip Schauer, and Tammy Fouse. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190608347.003.0006.

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Despite the presence of robust data on safety and efficacy of bariatric and metabolic surgery, many patients and physicians do not consider surgery to treat obesity, diabetes, and metabolic syndrome. One reason may be inaccurate beliefs about the risk-benefit ratios of medical and surgical treatments of obesity. Estimating the risk of postoperative complications can improve surgical decision-making and informed patient consent. Furthermore, there would be a considerable benefit in identifying modifiable preoperative conditions that are associated with increased risk of postoperative adverse events. The methodology and characteristics of online risk assessment tools in bariatric surgery are presented in this chapter.
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Ignatavicius, Donna D. Medical-Surgical Nursing - Single Volume - Text with FREE Study Guide and Virtual Clinical Excursions 3. 0 Package. Elsevier - Health Sciences Division, 2008.

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Cetin, Derrick. Medical Evaluation of the Bariatric Surgery Patient. Edited by Tomasz Rogula, Philip Schauer, and Tammy Fouse. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190608347.003.0002.

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Evaluation of the obese patient requires identification of all comorbidities and health conditions, including underlying cardiac and pulmonary conditions that could have a negative outcome on noncardiac surgery. Once comorbidities have been recognized, aggressive optimization of these medical conditions can provide improved outcomes after bariatric surgery. Estimating medical risk can be performed by several validated classification systems. The preoperative checklist and clinical practice guidelines (CPG) were updated in 2013. The CPG recommendations for preoperative evaluation of the bariatric surgery patient include lab testing, nutritional screening, endocrine assessment, and cardiopulmonary assessment, including sleep apnea screening. The CPG suggest an extensive multidisciplinary team approach to the preoperative bariatric surgery patient. Finally, the medical evaluation includes an algorithm for a seven-step approach to the preoperative visit. Also recommended for evaluation of the morbidly obese patient is an algorithm that uses a five-step approach after a comprehensive history and physical exam and lab testing.
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Beg, Yasmeen, and BobbieJean Sweitzer. Preoperative Patient Evaluation for Anesthesia Care Outside of the Operating Room. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190495756.003.0002.

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Increasing numbers of patients with serious comorbidities undergo procedures that require anesthesia services outside of the operating room (OOOR). A general anesthetic requiring instrumentation of the airway may pose a greater risk than many procedures performed in OOOR settings. A thorough review of the patient’s history and medical records should be undertaken as part of the preanesthetic assessment. Preprocedure testing is often unnecessary unless there is a medical indication or the results will alter management. The patient’s comorbidities and the nature of the procedure are considered when managing medications. Preparation to lower the risk of complications and improve outcomes during and after procedures requiring anesthesia is the most important goal. Identification and modification of risk are essential. As the numbers of patients having anesthesia in OOOR locations increase, anesthesiologists must continue to innovate to provide patients with the best preoperative services.
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DeMaria, Eric J., and Claudia Jin Kim. Evaluating Bariatric Surgical Risk Using Risk-Scoring Systems. Edited by Tomasz Rogula, Philip Schauer, and Tammy Fouse. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190608347.003.0004.

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Surgical risk assessment is a critical aspect of delivering safe bariatric and metabolic surgery care today. Years ago, there were no useful methodologies to differentiate morbidly obese patients based on surgical risk stratification. Today there are numerous available strategies that can identify patients at higher risk for complications and for otherwise poor results, such as insufficient weight loss and suboptimal resolution of comorbid medical conditions. These strategies can guide the preoperative evaluation, allow the provider to better inform the patient regarding risk, and allow for more aggressive perioperative care to be instituted on a selective basis, thus lowering overall costs of care. Identification of low-risk patients undergoing low-risk procedures has allowed for surgical treatment of some patients in free-standing surgical centers. In this chapter, we review available risk-stratification strategies that can be useful in the preoperative assessment of risk in the obese population undergoing bariatric surgery.
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Abatzis, Vaia T., and Edward C. Nemergut. Transsphenoidal/Pituitary Surgery. Edited by David E. Traul and Irene P. Osborn. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190850036.003.0004.

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Patients with tumors of the pituitary gland represent a heterogeneous yet commonly encountered neurosurgical population. Optimal anesthetic care requires an understanding of the complex pathophysiology secondary to each patient’s endocrine disease. Although patients presenting with Cushing’s disease and acromegaly have unique manifestations of endocrine dysfunction, all patients with tumors of the pituitary gland require meticulous preoperative evaluation and screening. There are many acceptable strategies for optimal intraoperative anesthetic management; however, the selection of anesthetic agents should be tailored to facilitate surgical exposure, preserve cerebral perfusion and oxygenation, and provide for rapid emergence and neurological assessment. Postoperatively, careful monitoring of fluid balance and serum sodium is essential to the early diagnosis of diabetes insipidus (DI). DI is most often transient but can require medical therapy. A thorough understanding of the preoperative assessment, intraoperative management, and potential complications are fundamental to successful perioperative patient care and avoidance of morbidity and mortality.
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Book chapters on the topic "Preoperative medical assessment"

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Roser, Steven M., and Gary F. Bouloux. "Medical Management and Preoperative Patient Assessment." In Peterson’s Principles of Oral and Maxillofacial Surgery, 19–51. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-91920-7_2.

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Beck, David E., Patricia L. Roberts, John L. Rombeau, Michael J. Stamos, and Steven D. Wexner. "Preoperative Management: Risk Assessment, Medical Evaluation, and Bowel Preparation." In The ASCRS Manual of Colon and Rectal Surgery, 159–80. New York, NY: Springer New York, 2009. http://dx.doi.org/10.1007/b12857_8.

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Delaney, Conor P., and John M. MacKeigan. "Preoperative Management—Risk Assessment, Medical Evaluation, and Bowel Preparation." In The ASCRS Textbook of Colon and Rectal Surgery, 116–29. New York, NY: Springer New York, 2007. http://dx.doi.org/10.1007/978-0-387-36374-5_8.

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Ho, Roger H. Y., and David M. H. Lam. "Preoperative assessment." In Oxford Textbook of Anaesthesia for Oral and Maxillofacial Surgery, Second Edition, 1–18. 2nd ed. Oxford University PressOxford, 2022. http://dx.doi.org/10.1093/med/9780198790723.003.0001.

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Abstract The aims of preoperative assessment are to evaluate and optimize pre-existing medical conditions and medications, to stratify the risk of perioperative complications, and to inform the planning of perioperative care. This chapter outlines the specific challenges brought about by the range of different oromaxillofacial pathologies requiring surgery, airway evaluation and planning, the preoperative management of patients with pre-existing medical conditions in the context of oromaxillofacial surgery, environmental considerations, the preoperative management of commonly encountered long-term medications, and the various risk stratification tools available to facilitate optimal planning of the perioperative care.
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Qasim, Atif, and David Horowitz. "Preoperative Cardiovascular Risk Assessment." In Evidence-Based Medical Consultation, 90–123. Elsevier, 2007. http://dx.doi.org/10.1016/b978-141602213-8.50007-5.

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Jibawi, Abdullah, Mohamed Baguneid, and Arnab Bhowmick. "Preoperative assessment." In Current Surgical Guidelines, edited by Abdullah Jibawi, Mohamed Baguneid, and Arnab Bhowmick, 55–78. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198794769.003.0007.

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All patients scheduled for procedures should undergo preoperative assessment. The process should aim to identify, evaluate, and optimize medical comorbidities that may otherwise have an adverse effect on outcome. In addition, it provides an opportunity to ensure that the patient comprehends the proposed procedure and is happy to proceed. A complete assessment including history, examination, ASA grade, and consideration of functional status should be performed by an appropriate health professional. Investigations should be performed only if they contribute to the preoperative process and subsequent management of the patient. Physicians should be vigilant of pre-existing cardiac or respiratory disease as these two systems are the most common cause of perioperative complications. A more thorough workup may be indicated in these cases and risk reduction strategies put in place.
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ZIRING, BARRY S. "Preoperative Assessment for the Healthy Patient." In Medical Management of the Surgical Patient, 15–33. Elsevier, 2008. http://dx.doi.org/10.1016/b978-141602385-2.50003-2.

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Dhesi, Jugdeep, and Judith Partridge. "Preoperative assessment and perioperative management." In Oxford Textbook of Geriatric Medicine, 261–72. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198701590.003.0036.

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The demographic changes in the surgical population pose a new challenge for geriatricians. Despite symptomatic and survival benefits following surgery, older people consistently suffer from excess medical morbidity, mortality, and adverse functional outcomes. This is predominantly related to physiological change, multimorbidity, and geriatric syndromes. For these reasons, geriatricians are increasingly asked for their medical and rehabilitation expertise in the management of elective and emergency surgical patients. This chapter describes the goals of preoperative risk assessment, modification of risk through medical and functional optimization, and presents different models of care which can be employed in older patients. The evidence behind comprehensive geriatric assessment in the surgical setting is presented, including discussion about collaborative decision-making and effective communication involving older patients, their relatives, surgeons, anaesthetists, physicians, and allied health professionals in the perioperative period. The future challenges in terms of research, education, and service development are discussed.
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Munshi, Aditya, and Geno Merli. "Preoperative Evaluation of Neurosurgical Patients." In Medical Management of Neurosurgical Patients, 16–29. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190913779.003.0002.

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All patients undergoing noncardiac surgery are exposed to a risk of adverse surgical, anesthesia, and medical complications. Unlike procedural risk, the medical risks are often modifiable, and therefore stratification of patient medical risk prior to surgery forms the basis of reducing postoperative morbidity, mortality, and length of hospital stay. Patients undergoing neurosurgical procedures pose several unique challenges and require special focus. This patient subgroup also carries a high risk for thrombotic events from immobilization and interruption of pharmacological prophylaxis. Cardiovascular events occurring in the postoperative period are the primary focus of risk assessment in noncardiac surgery, and this is also true for neurosurgical procedures, many of which are performed emergently or urgently. The authors discuss cardiovascular risk stratification based on a patient’s functional status, exercise capacity, and prior cardiac history. They review risk assessment scales to aid decision-making and how to select patients for further testing. Bleeding complications can be devastating and are of great concern in neurosurgery; the chapter discusses assessment of bleeding risk using an approach that combines basic laboratory testing with a thorough history and physical exam. The authors address the risk of thromboembolic events in neurosurgery patients and provide recommendations for preoperative assessment and postoperative prophylaxis. This chapter covers a broad approach from the point of view of a hospitalist physician evaluating a patient preoperatively, including a review of current guidelines, recommendations, and future directions on risk stratification for cardiac, thrombotic, and bleeding complications.
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Abbott, Tom, and Rupert Pearse. "Assessing and preparing patients with medical conditions for major surgery." In Oxford Textbook of Medicine, edited by Simon Finfer, 3860–66. Oxford University Press, 2020. http://dx.doi.org/10.1093/med/9780198746690.003.0387.

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The assessment of patients before surgery is complex. However, since surgery is offered to increasing numbers of patients with multiple comorbidities, the demand for comprehensive preoperative assessment is expected to increase. Perioperative medicine provides a patient-centred approach from preoperative assessment through to hospital discharge and beyond. Preoperative assessment serves to identify comorbidity that may require optimization before surgery, plan perioperative care, identify a need for a non-standard anaesthetic technique, assess functional reserve, brief patients on the perioperative care pathway, and provide an opportunity to have questions answered. There are a variety of tools for preoperative assessment and recognized approaches to managing patients with existing chronic disease during the perioperative period, but the absence of robust evidence to favour any particular clinical approach is striking.
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Conference papers on the topic "Preoperative medical assessment"

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Chakraborty, Jayasree, Jian Zheng, Mithat Gönen, William R. Jarnagin, Ronald P. DeMatteo, Richard K. G. Do, and Amber L. Simpson. "Preoperative assessment of microvascular invasion in hepatocellular carcinoma." In SPIE Medical Imaging, edited by Samuel G. Armato and Nicholas A. Petrick. SPIE, 2017. http://dx.doi.org/10.1117/12.2255622.

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Bouamrane, Matt-Mouley, Alan Rector, and Martin Hurrell. "Development of an ontology for a preoperative risk assessment clinical decision support system." In 2009 22nd IEEE International Symposium on Computer-Based Medical Systems (CBMS). IEEE, 2009. http://dx.doi.org/10.1109/cbms.2009.5255251.

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Cavalcante, Emmanuel Filizola, Nathaniel dos Santos Sousa, Paulo Victor Almeida Miguel, Luiz Gonzaga Porto Pinheiro, and Karla Sorandra Rodrigues Oliveira. "THE USE OF BREAST MOLDS IN PREOPERATIVE MARKINGS FOR ONCOPLASTIC SURGERIES." In Scientifc papers of XXIII Brazilian Breast Congress - 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s1069.

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Abstract:
Introduction: Breast cancer (BC) is a major public health problem worldwilde, with a high incidence in young women in Brazil. In this context, treatment with oncoplastic surgery represents a major advance, through the combination of plastic and oncological surgery techniques, maintaining the breast contour and reducing the psychological impact of radical surgeries. Preoperative marking plays an important role in the aesthetic result and reference points are marked freehand in order to guide the incisions. Objectives: To present an efficient and low-cost option, through a mold, to perform preoperative marking in oncoplastic surgeries with pedicle. Methods: Between March and December 2020, ten oncoplastic surgeries (with pedicle technique) were performed in women with BC and moderate to large volume ptotic breasts at Clínica Arte de Cuidar, Santa Casa de Misericórdia de Sobral and Grupo de Educação e Estudos Oncológicos. A personalized acrylic mold with two holes was used in the preoperative marking. The distance between hole n.1 to the top edge is 2 cm and from to the bottom edge 3 cm. Once the A point of the breast is defined – (the site of the future papillary areola complex), the hole n.11 of the mold is placed right at point A of the breast. Then we settle the hole n. 2 of the mold in the line drawn from the nipple to the breast groove and mark the superior part. In the process, we use the side of the mold - that measures 6.5 cm - or a measuring tape to determine the amount of tissue and skin to be removed. The distance from the inferior border of the areola to the infra-mammary groove is usually 5–6 cm. It the end, all patients were followed up with regular medical consultations and with pre and postoperative photographs. Results: With subjective assessment of shape, volume and symmetry, all patients were satisfied with the procedure performed. In most cases the areolas remained rounded. And, most importantly, there were no complications in between - such as skin necrosis or papillary areola complex, important asymmetries and moderate or large dehiscences. Conclusions: The creation and use of a breast mold is still a challenge due to the variety of breasts, so, in that way, oncoplastic surgery must always be individualized. The preoperative marking with a mold can contribute to reduction of the surgery duration and increase the satisfaction with the aesthetic.
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