Pre-Operative Evaluations
Roughly 28 million patients undergo surgery in the United States each year. Preoperative risk assessments provide an opportunity to reduce hospitalization stay, rates of complications, and even mortality. All patients who are scheduled to undergo a noncardiac surgery should have a preoperative physical exam, and a risk assessment performed to predict the risk for a perioperative (around the time of surgery) cardiac event.
The goal of a preoperative evaluation is to assess risk, offer recommendations for a risk, and to improve a patient’s functional status prior to an elective surgery. Optimizing your preoperative medical conditions and identifying unrecognized comorbid disease prior to surgery is of the utmost importance to give the patient the best opportunity for success. At this visit, we will obtain a comprehensive medical history, a complete physical exam, and evaluate a patients exercise and functional capacity. We will review all current prescription, over the counter medications, supplements, and herbal medicine. We will discuss which medications should be continued prior to surgery, which should be stopped, and which should be reduced.
Laboratory assessment may include a Complete Blood Count (CBC), a Comprehensive Metabolic Panel (CMP), PT/INR, Urinalysis. Other testing including Electrocardiogram (EKG), Pulmonary Function Testing (PFTs), Chest Xray, cardiac stress testing, sleep study, pacemaker check, and echocardiogram may be obtained if indicated
Common exclusions for elective surgery include recent MI (myocardial infarction, heart attack) within 60 days or unstable angina, decompensated heart failure, high-grade arrhythmias, or hemodynamically valvular heart disease (ie aortic stenosis).