The yield of routine pre-operative cardiovascular evaluation in stable patients scheduled for elective non-cardiac surgery

“…Further, the incidence of abnormal ECGs is very low in patients under 65 years old. According to the American College of Cardiology/American Heart Association (ACC/ AHA) guidelines, preoperative ECG should be performed on patients with known heart disease, peripheral arterial dis-ease, or cerebrovascular disease [10,11]. Accordingly, implementation of these ACC/AHA guidelines in a preoperative clinic led to a reduction in exercise stress testing, lower hospital length of stay, increased beta-blocker therapy, and improved preoperative testing appropriateness while preserving a low cardiac complication rate [12].…”

Section: Electrocardiogrammentioning

confidence: 99%

“…10 Frailty score has been described as an age-associated decline in five domains: shrinking, weakness, exhaustion, low physical activity, and slow walking speed[113] …”

mentioning

confidence: 99%

Preoperative Evaluation in Colorectal Patients

Landmann

Francone

2021

The ASCRS Textbook of Colon and Rectal Surgery

View full text Add to dashboard Cite

Patients undergoing elective abdominal colorectal operations are in the "intermediate" risk group for perioperative morbidity and mortality. • Recognition and optimization of concomitant patient pathophysiology are paramount in minimizing sepsis (anastomotic leak, surgical site infection), complications, and overall morbidity. • These include cardiopulmonary, renal, metabolic, and endocrine physiology and other pathophysiologic risk factors and derangements (such as frailty and immunosuppression). • Implementation of ACC/AHA guidelines and evidencebased medical management leads to improved efficiencies with minimization of extraneous testing and delays, while preserving low complication rates. • Corticosteroids and immunosuppression remain significant determinants of morbidity in patients undergoing intestinal colorectal surgery. • Prehabilitation of the frail and elderly patient is critical in optimizing patients for surgery while attempting to mitigate perioperative morbidity and mortality. Evaluation of the Routine Colorectal Patients In Office by SurgeonA detailed history and physical examination are paramount to the evaluation and optimal management of a preoperative patient. A thorough review of the patient's chief complaint as well as associated signs and symptoms and confounding issues or factors is necessary to synthesize an appropriate diagnosis and perioperative plan. Careful attention to the patient's medical comorbidities and past surgical history, as well as review and reconciliation of the patient's medications, is relevant to help coordinate perioperative management and operative planning. In patients who require multidisciplinary care such as inflammatory bowel disease and rectal cancer, it is imperative to ascertain the other specialists' contact information for optimal coordination of care. Similarly, specialist communication should be coordinated for patients who have significant cardiopulmonary disease or other major medical comorbidities. Personal review of source documentation for pertinent pathology, endoscopy, and radiological findings is critical in establishing a diagnosis and individualized plan of care. In many cases, the above may require coordination among more than one physician and more than one healthcare organization to achieve optimal perioperative care and outcomes, while minimizing morbidity.

show abstract

“…Mortality rates for these procedures can be as high as 4% depending on the patient's risk and type of surgery. 6 Cardiovascular complications account for half of all morbidities and mortalities in the perioperative period for patients undergoing non-cardiac surgery. This is considered a significant contributing factor to perioperative morbidity and mortality.…”

mentioning

confidence: 99%

The Philippine College of Surgeons Evidence-Based Clinical Practice Guidelines on Preoperative Evaluation of ASA I and II Adult Patients Undergoing Elective Non-Cardiac Surgery

De Dios,

Abella,

Ona

et al. 2017

Philipp J Surg Spec

View full text Add to dashboard Cite

The yield of routine pre-operative cardiovascular evaluation in stable patients scheduled for elective non-cardiac surgery

Cited by 9 publications

References 10 publications

3rd GUIDELINE FOR PERIOPERATIVE CARDIOVASCULAR EVALUATION OF THE BRAZILIAN SOCIETY OF CARDIOLOGY

3rd GUIDELINE FOR PERIOPERATIVE CARDIOVASCULAR EVALUATION OF THE BRAZILIAN SOCIETY OF CARDIOLOGY

Preoperative Evaluation in Colorectal Patients

The Philippine College of Surgeons Evidence-Based Clinical Practice Guidelines on Preoperative Evaluation of ASA I and II Adult Patients Undergoing Elective Non-Cardiac Surgery

Contact Info

Product

Resources

About