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Journal articles on the topic 'Preoperative medical assessment'

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Published: 10 December 2022
Last updated: 28 January 2023

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1

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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2

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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3

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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4

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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5

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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7

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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8

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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9

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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10

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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11

Ng, Austin Chin Chwan, and Leonard Kritharides. "Diagnostic tests: Preoperative assessment: a cardiologist’s perspective." Australian Prescriber 37, no. 6 (December 1, 2014): 188–91. http://dx.doi.org/10.18773/austprescr.2014.079.

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12

Björkström, Lollo Makdessi, Ninnie Borendal Wodlin, Lena Nilsson, and Preben Kjølhede. "The Impact of Preoperative Assessment and Planning on the Outcome of Benign Hysterectomy – a Systematic Review." Geburtshilfe und Frauenheilkunde 81, no. 02 (February 2021): 200–213. http://dx.doi.org/10.1055/a-1263-0811.

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AbstractKnowledge concerning the impact of preoperative planning, patient information and patient factors on the outcome of benign hysterectomy is incomplete. This systematic review summarizes the current knowledge on the effect of preoperative planning and of preoperative patient factors on the outcome of benign hysterectomy. The PubMed/PubMed Central/MEDLINE, Scopus, Web of Science, TRIP Medical Database, Prospero and the Cochrane Library databases were searched. Inclusion criteria were prospective trials, hysterectomy for benign disease, systematic preoperative assessment, and article in English. Eighteen articles were included and categorized according to their main aims: use of a preoperative checklist, preoperative decision-making, preoperative information, and the effect on the outcome of surgery of factors that concerns patients preoperatively. Focused and well directed preoperative assessment and thoroughness in the preoperative decision-making was associated with positive postoperative outcomes. The use of a checklist reduced the overall rate of hysterectomy and increased the use of minimally invasive surgery. Women were often inadequately informed before hysterectomy about the possible side effects after surgery. Preoperative anxiety and preoperative pain were associated with postoperative pain and lower quality of life. The indication for surgery had an impact on the reported quality of life postoperatively. The extent of preoperative planning seemed to affect the outcome of surgery. Preoperative patient factors influenced the postoperative recovery. Prehabilitation measures need further development and should be integrated in the preoperative planning. Prospective studies are warranted to evaluate and improve the preoperative planning in a systematic setting before performing hysterectomy for benign disease.
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Thanavaro, Joanne L., and Barbara J. Fonner. "Preoperative Cardiac Risk Assessment and Medical Management for Noncardiac Surgery." Journal for Nurse Practitioners 8, no. 5 (May 2012): 354–64. http://dx.doi.org/10.1016/j.nurpra.2012.02.018.

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14

Gardiner, A. J. S. "Manual of Surgical Clearance Regarding Medical Assessment of Preoperative Patients." Postgraduate Medical Journal 66, no. 777 (July 1, 1990): 585–86. http://dx.doi.org/10.1136/pgmj.66.777.585-a.

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15

Delaney, Dee, Pat Olszewsky, Jean Gallagher, Elizabeth W. Bayley, Laurie Duckworth, and Kaye Labman. "Parental Satisfaction With Pediatric Preoperative Assessment and Education." Journal of PeriAnesthesia Nursing 28, no. 3 (June 2013): e44-e45. http://dx.doi.org/10.1016/j.jopan.2013.04.130.

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16

Glover, Nicholas P., Denise H. Tola, William Norcross, Lindsey Naumuk, and Christine Tocchi. "Preoperative Cognitive Assessment Recommendations for the Older Adult." Journal of PeriAnesthesia Nursing 35, no. 5 (October 2020): 460–66. http://dx.doi.org/10.1016/j.jopan.2020.02.011.

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17

Barnett, Jennifer S. "An Emerging Role for Nurse Practitioners-Preoperative Assessment." AORN Journal 82, no. 5 (November 2005): 825–34. http://dx.doi.org/10.1016/s0001-2092(06)60275-5.

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18

Wilson, Kerryn, Indrani Lakheeram, Angie Morielli, Robert Brouillette, and Karen Brown. "Can Assessment for Obstructive Sleep Apnea Help Predict Postadenotonsillectomy Respiratory Complications?" Anesthesiology 96, no. 2 (February 1, 2002): 313–22. http://dx.doi.org/10.1097/00000542-200202000-00015.

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Background The aim of this study was to determine the frequency and type of respiratory complications after adenotonsillectomy in children. A second aim was to assess the ability of preoperative sleep studies to identify children at risk for respiratory complications. Methods Children referred for sleep studies between 1992 and 1998, who underwent adenotonsillectomy within 6 months of the preoperative study, were reviewed. The study focused on two variables: the obstructive apnea and hypopnea index and the oxygen saturation nadir. Medical charts were reviewed for postoperative respiratory complications. Results Three hundred forty-nine children were referred for sleep studies, and 163 met the inclusion criteria. Thirty-four children (21%) had postoperative respiratory complications requiring a medical intervention. Children experiencing respiratory complications were younger (aged &lt; 2 yr; adjusted odds ratio, 4.3; 95% confidence interval, 1.7-11) and had an associated medical condition (odds ratio, 3; 95% confidence interval, 1.4-6.5). A preoperative obstructive apnea and hypopnea index of 5 or more events per hour increased the chance of postoperative respiratory complications (odds ratio, 7.2; 95% confidence interval, 2.7-19.3), as did a preoperative oxygen saturation nadir of 80% or less (odds ratio, 6.4; 95% confidence interval, 2.8-14.5). A preoperative oxygen saturation nadir of 80% or less had a likelihood ratio of 3.1, increasing the probability of postoperative respiratory complications from 20 to 50%. Conclusions The data suggest, but do not prove, that preoperative nocturnal oximetry could be a useful preoperative test to identify children who are at increased risk for postoperative respiratory complications.
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Gruss, C. L., J. M. Ehrenfeld, and J. P. Wanderer. "Using Visual Analytics to Determine the Utilization of Preoperative Anesthesia Assessments." Applied Clinical Informatics 06, no. 04 (2015): 629–37. http://dx.doi.org/10.4338/aci-2015-02-cr-0022.

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Summary Background: Preoperative assessments are a required and essential element of anesthetic care, yet little is known about the utilization of these documents by clinicians who are not part of the anesthesia care team. As part of perioperative workflow restructuring, we implemented a data visualization technique of electronic medical record audit log data to understand the utilization of preoperative anesthesia assessments by non-anesthesia personnel. Methods: An audit log cache containing 140 days of data was queried for all accesses of preoperative anesthesia assessment documents for any patient who had a preoperative anesthesia assessment that was accessed during that period. User roles were aggregated into categories. Descriptive statistics and data visualization were generated using R (R Software Foundation, Vienna, Austria). Comparisons were performed with the Wilcoxon signed rank test with continuity correction. Results: During the study period, 73 802 (0.015%) of the 485 062 902 audit log accesses were pre-operative anesthesia assessments representing 412 departments, 302 user roles, and 3 916 distinct users who accessed preoperative anesthesia assessments from 14 235 surgical cases. Each assessment was accessed 2.9 times on average. Assessments performed in the preoperative anesthesia assessment clinic were accessed more frequently than those created on the day of surgery in the preoperative holding room (3.58 ± 5.18 v. 1.98 ± 1.76 average views; p<0.0001). We observed accesses of these documents by pathology and general surgery researchers, as well as orthopedics attending physicians accessing documents that were two years old. Conclusions: This approach revealed patterns of utilization that had not been previously identified, including usage by surgical residents, surgical faculty, and pathology researchers both before and after the surgical event for which the documents are generated. Knowledge of these dependencies directly informed perioperative workflow restructuring efforts. This visual analytic approach could be broadly utilized to understand documentation dependencies in a variety of clinical contexts.
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Hallman, Matthew J., Nancy Dorinsky, Yueting Wang, Quefeng Li, Robert Isaak, Lavinia Kolarczyk, Hong J. Kim, and Andrew J. Lobonc. "Objective postoperative pain assessment using incentive spirometry values: a prospective observational study." Pain Management 11, no. 3 (May 2021): 315–24. http://dx.doi.org/10.2217/pmt-2020-0080.

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Aim: Determine if incentive spirometry (IS) values correlate with postoperative pain control. Design: Prospective observational study. Setting & participants: A total of 100 patients undergoing major abdominal procedures at the University of North Carolina Medical Center. Interventions: Patients studied as a single cohort. All patients received thoracic epidural analgesia preoperatively. Outcome: Preoperative and daily postoperative numeric pain scores, subjective pain description and IS values were collected for all patients. Results: There was a strong correlation with IS values relative to baseline for both the numeric pain scores (p < 0.0001), postoperative day (p < 0.0001) and the subjective pain score (p < 0.0007). Conclusion: IS values are an objective surrogate data point for pain control after surgery, particularly when followed over time and compared with a preoperative baseline value.
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Lorick, Morgan. "Increasing Skin Assessment Adherence in the Preoperative Setting." AORN Journal 116, no. 4 (September 27, 2022): 327–30. http://dx.doi.org/10.1002/aorn.13787.

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Mangoni, Arduino A., Patrick Russell, and Elzbieta A. Jarmuzewska. "Preoperative polypharmacy assessment for risk stratification and management." British Journal of Clinical Pharmacology 88, no. 5 (February 15, 2022): 1952–54. http://dx.doi.org/10.1111/bcp.15271.

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23

Pham, Clarabelle T., Catherine L. Gibb, Robert A. Fitridge, and Jonathan D. Karnon. "Effectiveness of preoperative medical consultations by internal medicine physicians: a systematic review." BMJ Open 7, no. 12 (December 2017): e018632. http://dx.doi.org/10.1136/bmjopen-2017-018632.

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ObjectiveClinics have been established to provide preoperative medical consultations, and enable the anaesthetist and surgeon to deliver the best surgical outcome for patients. However, there is uncertainty regarding the effect of such clinics on surgical, in-hospital and long-term outcomes. A systematic review of the literature was conducted to determine the effectiveness of preoperative medical consultations by internal medicine physicians for patients listed for elective surgery.DesignSystematic searches of MEDLINE, EMBASE, CINAHL, PubMed, Current Contents and the NHS Centre for Reviews and Dissemination were conducted up to 30 April 2017.SettingElective surgery.Study selectionRandomised controlled trials and non-randomised comparative studies conducted in adults.Outcome measuresLength of hospital stay, perioperative morbidity and mortality, costs and quality of life.ResultsThe one randomised trial reported that preadmission preoperative assessment was more effective than the option of an inpatient medical assessment in reducing the frequency of unnecessary admissions with significantly fewer surgical cancellations following admission for surgery. A small reduction in length of stay in patients was also observed. The three non-randomised studies reported increased lengths of stay, costs and postoperative complications in patients who received preoperative assessment. The timing and delivery of the preoperative medical consultation in the intervention group differed across the included studies.ConclusionFurther research is required to inform the design and implementation of coordinated involvement of physicians and surgeons in the provision of care for high-risk surgical patients. A standardised approach to perioperative decision-making processes should be developed with a clear protocol or guideline for the assessment and management of surgical patients.
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Chang, Jung Hyun, Hyo Jin Chung, Sungyoun Chun, Jung-ha Kim, Sung Joon Park, and Sei Young Lee. "Analysis of Routine ENT Preoperative Assessment Using Korean National Health Insurance Database." Korean Journal of Otorhinolaryngology-Head and Neck Surgery 65, no. 9 (September 21, 2022): 521–32. http://dx.doi.org/10.3342/kjorl-hns.2022.00241.

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Background and Objectives Preoperative assessment is one of the most important fields in surgery and anesthesia as it can reduce morbidity and mortality from surgery and detect abnormal findings not clinically observed through preoperative examination. However, excessive non-vital preoperative routine tests have been criticized. The aim of the study is to investigate the current use of elective preoperative evaluations using otorhinolaryngologic surgery covering patients of all ages with various levels of difficulty.Subjects and Method Using the Korean National Health Insurance Service National Sample Cohort data, we investigated 98890 subjects who underwent otorhinolaryngologic surgery during the year 2018. We evaluated sociodemographic characteristics, clinical characteristics, medical institutions, and operation characteristics of the subjects and analyzed in detail their routine blood and urine test items, sonographic exams and pulmonary function tests.Results There were differences in the implementation of preoperative blood and urine tests, sonographic exams and pulmonary function tests according to sociodemographic characteristics, types and locations of medical institutions. Old age, low socioeconomic status, comorbid condition, high Charlson’s Comorbidity Index, tertiary hospital were the factors that increased preoperative evaluation tests.Conclusion Appropriate preoperative evaluation is needed for predicting and preparing for the possibility of treatment complications as well as improving treatment quality while reducing costs for perioperative management.
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Popivanov, Petar, Sohail Bampoe, Terry Tan, and Paul Rafferty. "Development, implementation and evaluation of high-quality virtual preoperative anaesthetic assessment during COVID-19 and beyond: a quality improvement report." BMJ Open Quality 11, no. 4 (October 2022): e001959. http://dx.doi.org/10.1136/bmjoq-2022-001959.

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BackgroundPreoperative risk factor identification and optimisation are widely accepted as the gold standard of care for elective surgery and are essential for reducing morbidity and mortality. COVID-19 public health restrictions required a careful balance between ensuring best medical practices and maintaining safety by minimising patient face-to-face attendance in the hospital. Based on the successful implementation of telemedicine (TM) in other medical specialties and its feasibility in the preoperative context, this study aimed to develop, implement and evaluate a high-quality virtual preoperative anaesthetic assessment process.MethodsThe three-step model for improvement was used. The specific, measurable, actionable, relevant, time aim (step 1) and measures for improvement (step 2) were defined at the onset of the project. The plan–do–study–act tool was used for the structured implementation of improvement interventions (step 3) in three phases. Data relating to virtual and in-person referrals, assessments, did-not-attend (DNA) rate, consultation time, day of surgery delays and cancellations, and service-user and provider experience surveys were recorded prospectively.ResultsA total of 2805 patients were assessed in the preoperative anaesthetic assessment clinic between July 2020 and March 2021. The mean rate of virtual preoperative assessments was 50% (SD ±10) (1390/2805). 0.1% (30/2805) were inappropriately referred on the alternative pathway. The DNA rate was 0.4% (8/1398) and 3% (43/1458) for virtual and in-person pathways, respectively. The mean consultation times for virtual and in-person attendance were 19 (SD ±7) and 31 (SD ±13) min, respectively. There were five same-day surgery cancellations and one delay due to medical reasons. When asked about their experience with the virtual assessment, both service users and providers reported high satisfaction, minimal technical difficulties and shared concerns about limited opportunities for physical examination.ConclusionThis is one of the first implementational studies to comprehensively outline the feasibility of TM in preoperative anaesthetic assessment during COVID-19.
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Yoshino, Masanori, Hirofumi Nakatomi, Taichi Kin, Toki Saito, Naoyuki Shono, Seiji Nomura, Daichi Nakagawa, et al. "Usefulness of high-resolution 3D multifusion medical imaging for preoperative planning in patients with posterior fossa hemangioblastoma: technical note." Journal of Neurosurgery 127, no. 1 (July 2017): 139–47. http://dx.doi.org/10.3171/2016.5.jns152646.

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Successful resection of hemangioblastoma depends on preoperative assessment of the precise locations of feeding arteries and draining veins. Simultaneous 3D visualization of feeding arteries, draining veins, and surrounding structures is needed. The present study evaluated the usefulness of high-resolution 3D multifusion medical imaging (hr-3DMMI) for preoperative planning of hemangioblastoma. The hr-3DMMI combined MRI, MR angiography, thin-slice CT, and 3D rotated angiography. Surface rendering was mainly used for the creation of hr-3DMMI using multiple thresholds to create 3D models, and processing took approximately 3–5 hours. This hr-3DMMI technique was used in 5 patients for preoperative planning and the imaging findings were compared with the operative findings. Hr-3DMMI could simulate the whole 3D tumor as a unique sphere and show the precise penetration points of both feeding arteries and draining veins with the same spatial relationships as the original tumor. All feeding arteries and draining veins were found intraoperatively at the same position as estimated preoperatively, and were occluded as planned preoperatively. This hr-3DMMI technique could demonstrate the precise locations of feeding arteries and draining veins preoperatively and estimate the appropriate route for resection of the tumor. Hr-3DMMI is expected to be a very useful support tool for surgery of hemangioblastoma.
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FLANAGAN, K. "Preoperative assessment: Safety considerations for patients taking herbal products." Journal of PeriAnesthesia Nursing 16, no. 1 (February 2001): 19–26. http://dx.doi.org/10.1016/s1089-9472(01)18321-8.

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Abbas, Tariq O., Noora Al-Shahwani, Ahmed Hayati, Abdul Hady Samaha, Ibrahim E. Bassiouny, and Mansour Ali. "Role of Ultrasonography in the Preoperative Assessment of Impalpable Testes: A Single Center Experience." ISRN Urology 2012 (March 22, 2012): 1–3. http://dx.doi.org/10.5402/2012/560216.

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Background. Abdominoscrotal sonogram is often used in boys with a nonpalpable testis to determine the presence of the testis. We describe our experience with the use of ultrasonography in boys with a nonpalpable testis. Methods. We retrospectively reviewed the medical records of boys aged less than 14 years, who underwent preoperative ultrasonography for an impalpable undescended testis (IUDT) between 2006 and 2010 in our institution. The results of sonography and laparoscopy were compared. Results. A total of 26 impalpable testes in 22 patients, including 4 with bilateral impalpable testes, were preoperatively assessed by ultrasonography for their localization. Sonography localized only 6 of the 26 (23%) testes, which were laparoscopically explored and followed by orchiopexy. Conclusion. Ultrasound is not reliable in the preoperative assessment of patients with impalpable testes.
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Bader, A. "The preoperative assessment clinic: organization and goals." Ambulatory Surgery 7, no. 3 (July 1999): 133–38. http://dx.doi.org/10.1016/s0966-6532(98)00062-6.

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Becker, Daniel E. "Preoperative Medical Evaluation: Part 2: Pulmonary, Endocrine, Renal, and Miscellaneous Considerations." Anesthesia Progress 56, no. 4 (December 1, 2009): 135–45. http://dx.doi.org/10.2344/0003-3006-56.4.135.

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Abstract A thorough assessment of a patient's medical status is standard practice when dental care is provided. Although this is true for procedures performed under local anesthesia alone, the information gathered may be viewed somewhat differently if the dentist is planning to provide sedation or general anesthesia as an adjunct to dental treatment. This article, the second of a 2-part sequence on preoperative assessment, will address pulmonary and other noncardiovascular disorders.
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Allison, Jan, and Michelle George. "Using Preoperative Assessment and Patient Instruction to Improve Patient Safety." AORN Journal 99, no. 3 (March 2014): 364–75. http://dx.doi.org/10.1016/j.aorn.2013.10.021.

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Messias, Erick, and Christine E. Skotzko. "Psychiatric assessment in transplantation." Revista de Saúde Pública 34, no. 4 (August 2000): 415–20. http://dx.doi.org/10.1590/s0034-89102000000400018.

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The implementation of the presumptive donor law in Brazil is expected to increase the availability of organs for transplantation. As medical management of end-stage organ dysfunction continues to improve, increasing numbers of potential transplant recipients will be available to meet this supply. There is mounting evidence that supports the involvement of skilled psychiatric practitioners in the selection of transplant candidates. Data supporting the influence of psychosocial factors on compliance and therefore medical outcomes continues to grow. The literature review allows delineating the components and rationale for comprehensive psychosocial evaluations as a component of preoperative transplantation evaluation.
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Ewer, Michael S., and M. K. Ali. "Surgical treatment of the cancer patient: Preoperative assessment and perioperative medical management." Journal of Surgical Oncology 44, no. 3 (July 1990): 185–90. http://dx.doi.org/10.1002/jso.2930440312.

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34

JANECSKO, M., and K. NAGY. "3 Day care surgery in Hungary. Preoperative assessment." Ambulatory Surgery 12 (2005): S1. http://dx.doi.org/10.1016/s0966-6532(05)80004-6.

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Tariq, Hassan, Rafeeq Ahmed, Salil Kulkarni, Sana Hanif, Omesh Toolsie, Hafsa Abbas, and Sridhar Chilimuri. "Development, Functioning, and Effectiveness of a Preoperative Risk Assessment Clinic." Health Services Insights 9s1 (January 2016): HSI.S40540. http://dx.doi.org/10.4137/hsi.s40540.

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Lee first described the concept of preoperative assessment testing (PAT) clinic in 1949. An efficiently run clinic is associated with increased cost-effectiveness by lowering preoperative admission time and thus reducing the length of stay and the associated costs. The setup of the PAT clinic should be based on the needs, culture, and resources of the institution. Various models for the setup of PAT clinic have been described, including the concept of a perioperative surgical home, which is a patient-centered model designed to improve health and the delivery of health care and to reduce the cost of care. Although there are several constraints in the development of PAT clinics, with increasing awareness about the usefulness of pre-operative risk assessments, growing bodies of literature, and evidence-based guidelines, these clinics are becoming a medical necessity for the improvement of perioperative care.
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Dionigi, Gianlorenzo, Francesca Rovera, Luigi Boni, Marco Bellani, Alessandro Bacuzzi, Gianpaolo Carrafiello, and Renzo Dionigi. "Cancer of the esophagus: the value of preoperative patient assessment." Expert Review of Anticancer Therapy 6, no. 4 (April 2006): 581–93. http://dx.doi.org/10.1586/14737140.6.4.581.

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37

Becker, Daniel E. "Preoperative Medical Evaluation: Part 1: General Principles and Cardiovascular Considerations." Anesthesia Progress 56, no. 3 (September 1, 2009): 92–103. http://dx.doi.org/10.2344/0003-3006-56.3.92.

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Abstract A thorough assessment of a patient's medical status is standard practice when dental care is provided. Although this is true for procedures performed under local anesthesia alone, the information gathered may be viewed somewhat differently if the dentist is planning to use sedation or general anesthesia as an adjunct to dental treatment. This article is the first of a 2-part sequence and will address general principles and cardiovascular considerations. A second article will address pulmonary, metabolic, and miscellaneous disorders.
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Weinstein, Adam S., Martin I. Sigurdsson, and Angela M. Bader. "Comparison of Preoperative Assessment of Patient’s Metabolic Equivalents (METs) Estimated from History versus Measured by Exercise Cardiac Stress Testing." Anesthesiology Research and Practice 2018 (September 3, 2018): 1–5. http://dx.doi.org/10.1155/2018/5912726.

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Background. Preoperative anesthetic evaluations of patients before surgery traditionally involves assessment of a patient’s functional capacity to estimate perioperative risk of cardiovascular complications and need for further workup. This is typically done by inquiring about the patient’s physical activity, with the goal of providing an estimate of the metabolic equivalents (METs) that the patient can perform without signs of myocardial ischemia or cardiac failure. We sought to compare estimates of patients’ METs between preoperative assessment by medical history with quantified assessment of METs via the exercise cardiac stress test. Methods. A single-center retrospective chart review from 12/1/2005 to 5/31/2015 was performed on 492 patients who had preoperative evaluations with a cardiac stress test ordered by a perioperative anesthesiologist. Of those, a total of 170 charts were identified as having a preoperative evaluation note and an exercise cardiac stress test. The METs of the patient estimated by history and the METs quantified by the exercise cardiac stress test were compared using a Bland–Altman plot and Cohen’s kappa. Results. Exercise cardiac stress test quantified METs were on average 3.3 METS higher than the METs estimated by the preoperative evaluation history. Only 9% of patients had lower METs quantified by the cardiac stress test than by history. Conclusions. The METs of a patient estimated by preoperative history often underestimates the METs measured by exercise stress testing. This demonstrates that the preoperative assessments of patients’ METs are often conservative which errs on the side of patient safety as it lowers the threshold for deciding to order further cardiac stress testing for screening for ischemia or cardiac failure.
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Zwolan, Teresa A., and Ellen Thomas. "Contemporary Protocols for Evaluating Cochlear Implant Candidacy of Children." Perspectives on Hearing and Hearing Disorders in Childhood 19, no. 1 (March 2009): 4–13. http://dx.doi.org/10.1044/hhdc19.1.4.

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Abstract Candidacy criteria for determination of cochlear implantation for children have changed significantly since cochlear implants were first introduced. The contemporary evaluation process includes initial consultation, audiological assessment, speech and language assessment, preoperative counseling, selection of the ear to implant, medical evaluation, and additional assessments as needed. Ideally, an interdisciplinary team of professionals is involved in this evaluation process. The following article discusses procedures used in our clinic to determine a child's candidacy for a cochlear implant.
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Tappen, Ruth M., Janice Muzic, and Phyllis Kennedy. "Preoperative assessment and discharge planning for older adults undergoing ambulatory surgery." AORN Journal 73, no. 2 (February 2001): 464–74. http://dx.doi.org/10.1016/s0001-2092(06)61987-x.

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41

Plecha, E. J., T. A. King, H. C. Pitluk, and J. R. Rubin. "Risk Assessment in Patients Undergoing Carotid Endarterectomy." Cardiovascular Surgery 1, no. 1 (February 1993): 30–32. http://dx.doi.org/10.1177/096721099300100109.

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Factors that contribute to the outcome of carotid endarterectomy include appropriate patient selection, preoperative medical optimization, meticulous operative technique and postoperative management. This study was designed to evaluate associated medical and operative risk factors with surgical outcomes for 9795 consecutive carotid endarterectomies performed by members of a voluntary regional vascular society. All data were reviewed and subject to a variety of statistical analyses in a blinded retrospective fashion. Factors including sex, increased age (>70 years), cigarette smoking, chronic pulmonary disease and diabetes did not contribute independently to either increased operative neurologic morbidity or mortality rates. Cardiac disease ( P < 0.0001) and chronic renal failure ( P < 0.001) correlated independently with increased operative mortality, while hypertension ( P< 0.05), cardiac disease ( P< 0.01), renal failure ( P< 0.0001), emergency surgery ( P< 0.0001) and advanced neurologic symptoms at the time of operation ( P< 0.0001) were associated with an increased operative stroke rate. In a group of 9021 patients who underwent 9795 carotid endarterectomies with a combined 3.1% incidence of operative neurologic morbidity or mortality (neurologic morbidity, 2.0%; mortality, 1.5%), specific preoperative medical risk factors could be identified. Only cardiac disease and chronic renal failure were associated with both significantly increased operative neurologic morbidity and operative mortality rates.
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Rispoli, Marco, Fabio Perrotta, Salvatore Buono, and Antonio Corcione. "Role of a digital tool in preoperative lung resection surgery assessment." DIGITAL HEALTH 5 (January 2019): 205520761988578. http://dx.doi.org/10.1177/2055207619885783.

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The assessment of patients likely to undergo lung resection surgery is a multidisciplinary approach involving pulmonologists, surgeons and anaesthesiologists. In thoracic surgery, medical operability is also a calculation of postoperative lung function. A mobile application – PreParAPP MSD – to calculate postoperative lung function has been developed with the endorsement of the Italian Society of Anaesthesia, Analgesia and Intensive Care and with the unconditional support of MSD Italia. Thanks to a simple graphic interface, the calculation becomes fast and intuitive, while the possibility of storing and sharing data in an analytical and computerised way with other clinicians might help with the full assessment of patients without forcing them to undergo several medical examinations. These simple calculated parameters are performed by a minority of clinicians, generally anaesthesiologists. In our facility, there is a team involved in the perioperative evaluation of lung resection surgery (13 pulmonologists, 9 surgeons and 5 anaesthesiologists). In order to evaluate the possible Awareness towards postoperative lung function calculation better, we organised an internal survey with 27 clinicians who are members of such a team before and after the introduction of the PreParAPP MSD. It was found that after the introduction of PreParAPP MSD, the percentage of clinicians involved in postoperative lung function calculation rose from 18% to 70%. The implementation of a digital tool may help to improve guideline adherence, in accordance with other experiences in which such tools represented the start for various quality improvement purposes throughout the medical field.
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Levine, Jason C., and Rebecca C. Anderson. "Preoperative Assessment of Eating Disorders in Plastic Surgery Patients." Plastic Surgical Nursing 29, no. 1 (January 2009): 60–63. http://dx.doi.org/10.1097/01.psn.0000347727.95477.51.

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Coutinho, Thiago Pereira, Alexandre Sadao Iutaka, Alexandre Fogaça Cristante, Ivan Dias Rocha, Raphael Martus Marcon, Reginaldo Perilo Oliveira, and Tarcísio Eloy Pessoa de Barros Filho. "Functional assessment of patients with cervical myelopathy who underwent surgical treatment." Coluna/Columna 13, no. 1 (March 2014): 23–26. http://dx.doi.org/10.1590/s1808-18512014130100217.

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OBJECTIVE: Evaluate and correlate the functional response of patients with cervical myelopathy with the current clinical scores in patients who underwent surgical treatment. METHODS: We analyzed medical records of 34 patients with cervical myelopathy who underwent four different types of surgery. All patients were evaluated preoperatively and postoperatively with the application of the JOA and Nurick questionnaires. RESULTS: Functional clinical improvement was statistically significant. The mean preoperative JOA was 8.5 ± 3.06 and 10.7 ± 3.9 in the postoperative; Nurick was 3.2 ± 1.1 preoperatively and 2.8 ± 1.3 postoperatively. CONCLUSION: There is benefit with the surgical procedure in patients with cervical myelopathy. The neurological function after surgery depends on the previous function (the higher the duration of the previous symptoms, the greater the progression of the disease and, therefore, worse the neurological function) and the age is not a relevant factor of improvement, as already shown in other series. The clinical functional improvement of patients is visible with surgical treatment, regardless of surgical technique.
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Masud, Dr Sheikh, Dr Mahbubul Alam Choudhury, Dr Sirajul Islam Mondol, Dr Md Sazzad Haider Shahin, and Dr Shihab Mahmud Shahriar. "Clinical Staging for Accurate Preoperative Clinical Assessment of Patients with Nasopharyngeal Angiofibroma." Scholars Journal of Applied Medical Sciences 10, no. 10 (October 13, 2022): 1695–99. http://dx.doi.org/10.36347/sjams.2022.v10i10.018.

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Background: The location of the tumor and its accompanying symptoms, which include substantial epistaxis and nasal obstruction, cause the Nasopharyngeal Angiofibroma, a histologically and physiologically benign tumor with aggressive activity. Methods: The Otolaryngology & Head Neck Surgery division at Bangabandhu Shiekh Mujib Medical University, Dhaka Medical College Hospital, and Shaheed Suhrawardy Medical College Hospital in Dhaka carried out this retrospective cross-sectional study. The research was done in 2012, from February to November. 30 people made up the study's entire sample size. Result: The majority of individuals (54%) who have nasopharyngeal angiofibroma are between the ages of 16 and 20. People living in rural area (53.33%) are more sufferers from nasopharyngeal angiofibroma. The majority of patients have similar symptoms such epistaxis, nasal blockage, nasal discharge, anemia, and masses in the nasal cavity. Maximum (90%) has varying degree anaemia at presentation. All patient has soft tissue mass in Nasopharynx, half of the patient has pterygopalatine fossa extension at presentation. Maximum (56.66 %) patient admitted with stage II nasopharyngeal angiofibroma. Conclusion: It is necessary to acquire preoperative clinical staging and imaging parameters from data of one of the largest NA case series.
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46

Tsygan, Nikolay V., Victoria A. Yakovleva, Evgeniy E. Fufaev, Ismail R. Ismail R. Eleskhanov, Kirill V. Sapozhnikov, Vasilii M. Nechiporuk, Ilya I. Ilya I. Dzidzava, and Igor V. Litvinenko. "The preoperative assessment of the stroke risk in oncosurgery." Russian Military Medical Academy Reports 41, no. 4 (November 17, 2022): 365–70. http://dx.doi.org/10.17816/rmmar111863.

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AIM: of the research was to develop a mathematical model for the preoperative assessing of the stroke risk in surgical operations for malignant neoplasms of the chest and abdomen for the early identification of high-risk patients optimization of diagnostics and enhancing the efficacy of personalized preventive measures. MATERIALS AND METHODS: 47 cases of perioperative stroke according to archived case histories patients with malignant neoplasms of various localization retrospective analysis anamnesis of life and underlying disease, analysis of clinical and laboratory examination data, analysis of parameters associated with surgery and anesthetic aid, analysis of the clinical and neuroimaging picture of perioperative stroke; 102 patients who underwent elective surgery for the malignant neoplasm of the chest or abdomen perioperative dynamic neurological support collection of anamnesis of life and disease, analysis of clinical and laboratory examination data, neurological examination with NIHSS and mRankin scores, neuropsychological testing using MoCA and FAB. RESULTS: Risk factors for perioperative stroke in oncosurgical patients, as well as cerebroprotective factors have been established. The valid mathematical model was developed for assessing of the likelihood of perioperative stroke in the surgical treatment of malignant neoplasms of the chest and abdomen with a predictive power of 85.4%, sensitivity of 77%, and specificity of 87%. CONCLUSION: The proposed mathematical model allows preoperatively assess the risk of perioperative stroke in percentage (according to the anamnesis and medical records data) and identify the group of high-risk patients.
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Helsten, Daniel L., Arbi Ben Abdallah, Michael S. Avidan, Troy S. Wildes, Anke Winter, Sherry McKinnon, Mara Bollini, Penny Candelario, Beth A. Burnside, and Anshuman Sharma. "Methodologic Considerations for Collecting Patient-reported Outcomes from Unselected Surgical Patients." Anesthesiology 125, no. 3 (September 1, 2016): 495–504. http://dx.doi.org/10.1097/aln.0000000000001217.

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Abstract Background The impact of surgery on health is only appreciated long after hospital discharge. Furthermore, patients’ perceptions of postoperative health are not routinely ascertained. The authors instituted the Systematic Assessment and Targeted Improvement of Services Following Yearlong Surgical Outcomes Surveys (SATISFY-SOS) registry to evaluate patients’ postoperative health based on patient-reported outcomes (PROs). Methods This article describes the methods of establishing the SATISFY-SOS registry from an unselected surgical population, combining perioperative PROs with information from electronic medical records. Patients enrolled during their preoperative visit were surveyed at enrollment, 30 days, and 1-yr postoperatively. Information on PROs, including quality of life, return to work, pain, functional status, medical complications, and cognition, was obtained from online, mail, or telephone surveys. Results Using structured query language, 44,081 patients were identified in the electronic medical records as having visited the Center for Preoperative Assessment and Planning for preoperative assessment between July 16, 2012, and June 15, 2014, and 20,719 patients (47%) consented to participate in SATISFY-SOS. Baseline characteristics and health status were similar between enrolled and not enrolled patients. The response rate for the 30-day survey was 62% (8% e-mail, 73% mail, and 19% telephone) and for the 1-yr survey was 71% (13% e-mail, 78% mail, and 8% telephone). Conclusions SATISFY-SOS demonstrates the feasibility of establishing a PRO registry reflective of a busy preoperative assessment center population, without disrupting clinical workflow. Our experience suggests that patient engagement, including informed consent and multiple survey modalities, enhances PROs collection from a large cohort of unselected surgical patients. Initiatives like SATISFY-SOS could promote quality improvement, enable efficient perioperative research, and facilitate outcomes that matter to surgical patients.
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Lee, Ji Yeon, Kwang Joon Kim, Chang Oh Kim, and Kyung Hee Lee. "RELATIONSHIP OF PREOPERATIVE COMPREHENSIVE GERIATRIC ASSESSMENT TO HEALTH STATUS IN OLDER ADULTS." Innovation in Aging 3, Supplement_1 (November 2019): S684. http://dx.doi.org/10.1093/geroni/igz038.2525.

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Abstract Although comprehensive geriatric assessment has been widely used in surgical older adults, its relationship to health status has not been fully identified. This study aimed to examine the relationships of preoperative comprehensive geriatric assessment to frailty and length of stay. This was a descriptive study based on multi-professional health assessments found in electronic medical records. Study participants were 150 older adults in a neurosurgical department. The comprehensive geriatric assessment was comprised of nutrition, functional status, physical activity, depression, cognition, and basic items such as the Timed Up and Go test, grip strength, and self-rated health. Frailty level and length of stay were dependent variables which represented health status. The result showed that instrumental activities of daily living, physical activity, nutrition, self-rated health, and cognition were significantly associated with frailty. Specifically, comparing robustness with pre-frail and frail level, worseness in the instrumental activities of daily living, self-rated health, physical activity, and nutrition were associated with frailty. With progression of frailty level from pre-frail to frail, the worse score in the cognitive function and self-rated health were associated with frailty. In addition, more depressive symptoms, postoperative complications, and prolonged in the Timed Up and Go test were associated with lengthened hospital stay. Older adults with worsened status in physical, emotional, or cognitive function tended to be frail and stay longer in the hospital. Clinicians need to pay attention to the subcomponents of the comprehensive geriatric assessment and are encouraged to implement it to improve health status of surgical older adults.
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Maxim, Igor. "Preoperative evaluation of the pacient with bronchopulmonary cancer." Jurnalul de Chirurgie 17, no. 1 (April 20, 2021): 6–13. http://dx.doi.org/10.7438/jsurg.2021.01.02.

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BACKGROUND.In the Republic of Moldova, we have reported 983 cases of bronchopulmonary cancer (BPC) annually, in 2019. This impressive number of patients requires a more efficient mobilization of the medical system to solve these cases. AIM. The high incidence of newly diagnosed cases of BPC in advanced stages implies a reserved attitude for the surgical treatment of these patients, as well as the presence of associated pathologies, compromise more the situations, and the possibility to provide effective solutions to solve these cases. The group of patients who have tertiary prevention as a measure of treatment becomes imposing. This order of ideas outlines the need for a different medical-surgical approach for this category of patients. METHODS AND RESULTS.For the assessment of functional criteria for operability for patients with BPC, especially in advanced lung cancer, using comorbidity scores (ASA, Charlson, Elixhauser) and the formation of indications for surgical treatment are significant, because surgery offers the greatest opportunity for healing. The team responsible for the preoperative assessment should include both a perioperative mortality risk assessment and a postoperative pulmonary function prediction to optimally advise patients on anticipated outcomes. Due to both advanced cancer on presentation and comorbid conditions, only one-third of patients are ultimately considered candidates for surgical resection. Despite modern surgical, anesthetic, and postoperative techniques, there is still a perioperative mortality rate of 1-5%. Postoperative myocardial infarction is an important source of morbidity and mortality for those undergoing extensive lung resections, especially trans-pericardial pneumonectomies. Until surgery is suggested, preoperative evaluation of the cardiovascular system should be required for the existence of active heart disease (unstable angina, recent myocardial infarction, decompensated heart failure, arrhythmias, or valve defects).In addition to identifying cardiac risk factors, a preoperative assessment is incomplete without quantifying a patient's functional capacity. This can be achieved by the results of a formal stress test, measured in units of metabolic equivalents of task (MET). Geriatric assessment (GA) is a method used to collect information about the physical condition of elderly patients, which may be useful in estimating life expectancy and predicting treatment toxicity. GA includes an assessment of functional status, fatigue, cognitive function, mental health, nutritional status, the individual's ability to complete instrumental activities of daily living, comorbidities, social support, and the presence of geriatric syndromes. CONCLUSIONS. A thorough analysis of the results of diagnostic tests, referring to the functional evaluation of patients with advanced BPC and/or comorbidities, would allow the extension of surgical indications to obtain new results and increase over time the survival and quality of life of these patients.
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Beynon, Christopher, Shilai Wei, Alexander Radbruch, David Capper, Andreas W. Unterberg, and Karl L. Kiening. "Preoperative assessment of haemostasis in patients undergoing stereotactic brain biopsy." Journal of Clinical Neuroscience 53 (July 2018): 112–16. http://dx.doi.org/10.1016/j.jocn.2018.04.035.

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