Preoperative Assessment in Patients with Comorbidities: Key Strategies for Surgical Optimization and Reducing Perioperative Risk

The preoperative assessment is a crucial component in preparing patients with comorbidities for surgery. Identifying and optimizing pre-existing medical conditions can significantly reduce perioperative risk and improve surgical outcomes. In this context, it is essential for physicians to understand best practices and approaches for surgical optimization in complex patients.

Diving Deeper into Preoperative Assessment

The preoperative assessment should be a systematic process that considers multiple risk factors. A recent study highlights the importance of intraoperative hypotension and its relationship with renal and myocardial injuries, underscoring the need for strict blood pressure control during anesthesia [1]. Additionally, the preoperative evaluation for ambulatory anesthesia emphasizes the importance of obtaining a comprehensive medical history and establishing clear criteria for patient suitability, which can reduce cancellations and improve satisfaction for both patients and providers [2].

In geriatric patients, the preoperative assessment should include a comprehensive strategy that addresses comorbid diseases and functional deficits. A multidimensional approach can help identify and mitigate risks, thereby improving surgical outcomes [3]. Furthermore, cardiac prehabilitation has proven effective in enhancing postoperative outcomes through the implementation of proactive interventions prior to surgery [4].

Conclusions

The preoperative assessment in patients with comorbidities is an essential process that requires a meticulous and personalized approach. Early identification of modifiable risk factors and the implementation of surgical optimization strategies can significantly reduce perioperative risk. Interdisciplinary collaboration and the use of technological tools, such as electronic forms for cardiac risk assessment, can enhance efficiency and patient safety [5].

References

• [1] Relationship between Intraoperative Hypotension, Defined by Either Reduction from Baseline or Absolute Thresholds, and Acute Kidney and Myocardial Injury after Noncardiac Surgery: A Retrospective Cohort Analysis
• [2] Preoperative Evaluation for Ambulatory Anesthesia: What, When, and How?
• [3] Preoperative Assessment of Geriatric Patients
• [4] Cardiac Prehabilitation
• [5] Association of a Novel Electronic Form for Preoperative Cardiac Risk Assessment With Reduction in Cardiac Consultations and Testing: Retrospective Cohort Study

Created 13/1/2025