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Colegio de Medicina Interna de México.

2022, Number 6

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Med Int Mex 2022; 38 (6)

Preoperative assessment: from risk calculation to a comprehensive evaluation

Zavala-Jonguitud LF, Juárez-Villa JD, Olascoaga-Lugo A, Solís Flores-Padilla MG, Anda-Garay JC

Language: Spanish
References: 49
Page: 1210-1222
PDF size: 214.52 Kb.


ABSTRACT

Preoperative assessment is usually seen as a medical consult whose primary objective is to estimate a surgical risk based on predictive models. However, the global implication of this analysis is not always considered. The objective of this revision is to describe the scopes of preoperative assessment as an integral evaluation of the surgical patient, ranging from patient perioperative risk stratification to implementation of maneuvers that reduce the incidence of postoperative complications and mortality.


REFERENCES

  1. Meara JG, Leather AJ, Hagander L, Alkire BC, Alonso N,Ameh E, et al. Global Surgery 2030: evidence and solutionsfor achieving health, welfare, and economic development.Lancet 2015; 386 (9993): 569-624. https://doi.org/10.1016/S0140-6736(15)60160-X.

  2. Nepogodiev D, Martin J, Biccard B, Makupe A, BhanguA; National Institute for Health Research Global HealthResearch Unit on Global Surgery. Global burden of postoperativedeath. Lancet 2019; 393 (10170): 401. DOI:https://doi.org/10.1016/S0140-6736(18)33139-8.

  3. Sorensen LT. Wound healing and infection in surgery: Thepathophysiological impact of smoking, smoking cessation,and nicotine replacement therapy. Ann Surg 2012; 6 (255):1069-1079. doi: 10.1097/SLA.0b013e31824f632d.

  4. Gronkjaer M, Eliasen M, Skov-Ettrup LS, Tolstrup JS, ChristiansenAH, Mukkelsen SS, et al. Preoperative smokingstatus and postoperative complications. Ann Surg 2014;259 (1): 52-71. doi: 10.1097/SLA.0b013e3182911913.

  5. Wong J, Lam DP, Abrishami A, Chan MTW, Chung F. Shorttermpreoperative smoking cessation and postoperativecomplications: a systematic review and meta-analysis.Can J Anesth 2012; 52: 268-279. doi: 10.1007/s12630-011-9652-x.

  6. Eliasen M, Gronkjaer M, Skov-Ettrup LS, Mikkelsen SS, BeckerU, Tolstrup JS, et al. Preoperative alcohol consumptionand postoperative complications. Ann Surg 2013; 258 (6):930-942. doi: 10.1002/14651858.CD008343.pub3.

  7. Shabanzadeh DM, Tue Sorenden L. Alcohol consumptionincreases post-operative infection but not mortality: asystematic review and meta-analysis. Surg Infect 2015; 16:1-12. doi: 10.1089/sur.2015.009.

  8. Gustafsson UO, Scott MJ, Hubner M, Ngyren K, DemartinesN, Francis N, et al. Guidelines for perioperative carein elective colorectal surgery: Enhanced Recovery AfterSurgery (ERAS®) Society Recommendations: 2018. World JSurg 2019; 43: 659-695. doi: 10.1007/s00268-018-4844-y.

  9. Weimann A, Braga M, Harsanyi L, Laviano A, LjungqvistO, Soeters P, et al. ESPEN Guidelines on Enteral Nutrition:Surgery including organ transplantation. Clin Nutr 2006;25: 224-244. doi: 10.1016/j.clnu.2006.01.015.

  10. Weimann A, Braga M, Carli F, Higashiguchi T, Hübner M,Klek S, et al. ESPEN guideline: Clinical nutrition in surgery.Clin Nutr 2017; 36: 623-650.

  11. McClave SA, Taylor BE, Martindale RG, Warren MM, JohnsonDR, Braunschweig C, et al. ASPEN Board of Directors, AmericanCollege of Critical Care Medicine, Society of Critical CareMedicine. Guidelines for the provision and assessment of nutritionsupport therapy in the adult critically ill patient: societyof critical care medicine (SCCM) and american society forparenteral and enteral nutrition (ASPEN). J Parenter EnteralNutr 2016; 40: 159-211. doi: 10.1177/0148607115621863.

  12. Smith MD, McCall J, Plank L, Herbison GP, Soop M, NygrenJ. Preoperative carbohydrate treatment for enhancing recoveryafter elective surgery. Cochrane Database Sist Rev2014; 8: 1-91. doi: 10.1002/14651858.CD009161.pub2.

  13. Herbert G, Perry R, Andersen HK, Atkinson C, PenfoldC, Lewis SJ, et al. Early enteral nutrition within 24 hoursof lower gastrointestinal surgery versus later commencementfor length of stay and postoperative complications.Cochrane Database Syst Rev 2018; 10: 1-143. doi:10.1002/14651858.CD004080.pub3.

  14. Singer P, Reintam-Blaser A, Berger M, Alhazzani W, CalderP, Casaer M, et al. ESPEN guideline on clinical nutrition inthe intensive care unit. Clinical Nutrition 2019; 38: 48-79.

  15. Motonari R, Susumu A, Yasuyuki S. Obesity as a surgicalrisk factor. Ann Gastroenterol Surg 2018; 2: 13-21. doi:10.1002/ags3.12049.

  16. Lorente L, Ramón JM, Vidal P, Godat A, Parri A, LanzariniE, et al. Utilidad de la escala Obesity surgery mortalityrisk score en la predicción de complicaciones tras cirugíabariátrica por vía laparoscópica. Cir Esp 2014; 92 (5): 316-323. DOI: 10.1016/j.ciresp.2013.09.014

  17. Gallardo-Prieto LM, Nellen-Hummel H, Hamui-Sutton A,Castañón-González JA, Ibarra-Herrera E, Halabe-Cherem J.Perioperative evaluation in elderly patients. Cir Cir 2006;74 (1): 59-68.

  18. Mayor S. Age is not a risk factor for complications aftersurgery in older patients, review finds. BMJ 2018; 360:187. https://doi.org/10.1136/bmj.k187.

  19. Medina-Franco H, Ramos-De la Medina A, Torres-VillalobosG, Tapia-Cid de León H. Factores asociados a mortalidaden cirugía mayor: análisis retrospectivo en un centro dereferencia. Rev Invest Clín 2006; 58 (1): 9-14.

  20. Kristensen SD, Knuuti J, Saraste A, Anker S, Bøtker HE,Hert SD, et al. 2014 ESC/ESA Guidelines on non-cardiacsurgery: cardiovascular assessment and management: TheJoint Task Force on non-cardiac surgery: cardiovascularassessment and management of the European Society ofCardiology (ESC) and the European Society of Anaesthesiology(ESA). Eur Heart J 2014; 35 (35): 2383-431. doi:10.1093/eurheartj/ehu282.

  21. Bainbridge D, Martin J, Arango M, Cheng D. Perioperativeand anaesthetic-related mortality in developed anddeveloping countries: a systematic review and metaanalysis.Lancet 2012; 380: 1075-81. doi: 10.1016/S0140-6736(12)60990-8.

  22. Fleisher LA, Fleischmann KE, Auerbach AD, BarnasonSA, Beckman JA, Bozkurt B, et al. American College ofCardiology; American Heart Association: 2014 ACC/AHAguideline on perioperative cardiovascular evaluation andmanagement of patients undergoing non-cardiac surgery:A report of the American College of Cardiology/AmericanHeart Association Task Force on practice guidelines. J AmColl Cardiol 2014; 64: e77-137.

  23. Glance L, Faden E, Dutton R, Lustik S, Li Y, Eaton M, et al.Impact of the choice of risk model for identifying low-riskpatients using the 2014 American College of Cardiology/American Heart Association Perioperative Guidelines.Anesthesiology 2018; 129 (5): 889-900. doi: 10.1097/ALN.0000000000002341.

  24. Guía de Práctica Clínica Valoración Preoperatoria en Cirugíano Cardiaca en el Adulto. México: Secretaría de Salud, 2010.

  25. POISE Study Group, Devereaux PJ, Yang H, Yusuf S, GuyattG, Leslie K, Villar JC, et al. Effects of extended-releasemetoprolol succinate in patients undergoing non-cardiacsurgery (POISE trial): a randomised controlled trial.Lancet 2008; 371 (9627): 1839-47. doi: 10.1016/S0140-6736(08)60601-7.

  26. Duceppe E, Parlow J, MacDonald P, Lyons K, McMullenM, Srinathan S, et al. Canadian Cardiovascular SocietyGuidelines on Perioperative Cardiac Risk Assessmentand Management for Patients Who Undergo NoncardiacSurgery [published correction appears in Can J Cardiol2017; 33 (12): 1735]. Can J Cardiol 2017; 33 (1): 17-32.doi: 10.1016/j.cjca.2016.09.008.

  27. Daabiss M. American Society of Anaesthesiologists physicalstatus classification. Indian J Anaesth 2011; 55 (2): 111-115.doi: 10.4103/0019-5049.79879.

  28. Chan D, Sim Y, Chan Y, Poopalalingam R, Abdullah H. Developmentof the combined assessment of risk encounteredin surgery (CARES) surgical risk calculator for prediction ofpostsurgical mortality and need for intensive care unit admissionrisk: a single-center retrospective study. BMJ Open2018; 8(3): e019427. doi: 10.1136/bmjopen-2017-019427.

  29. Dakik HA, Chehab O, Eldirani M, Sbeity E, Karam C, Abou-Hassan O, et al. A new index for pre-operative cardiovascularevaluation. J Am Coll Cardiol 2019; 73 (24): 3067-3078.doi: 10.1016/j.jacc.2019.04.023.

  30. Wilcox T, Smilowitz NR, Xia Y, Berger JS. Cardiovascularrisk scores to predict perioperative stroke in noncardiacsurgery. Stroke 2019; 50 (8): 2002-2006. https://doi.org/10.1161/STROKEAHA.119.024995.

  31. Alrezk R, Jackson N, Al Rezk M, Elashoff R, Weinstraub N,Elashoff D, et al. Derivation and validation of a geriatricsensitiveperioperative cardiac risk index. J Am Heart Assoc2017; 6 (11): e006648. doi: 10.1161/JAHA.117.006648.

  32. Hlatky MA, Boineau RE, Higginbotham MB, Lee K, MarkDB, Califf RM, et al. A brief self-administered questionnaireto determine functional capacity (the Duke ActivityStatus Index). Am J Cardiol 1989; 64 (10): 651-654. doi:10.1016/0002-9149(89)90496-7.

  33. Melon C, Eshtiaghi P, Luksun W, Wijeysundera D. Validatedquestionnaire vs physicians’ judgment to estimate preoperativeexercise capacity. JAMA 2014; 174 (9): 1507. doi:10.1001/jamainternmed.2014.2914.

  34. Wijeysundera DN, Pearse RM, Shulman MA, Abbott T,Torres E, Ambosta A, et al. Assessment of functional capacitybefore major non-cardiac surgery: an international,prospective cohort study. Lancet 2018; 391 (10140): 2631-2640. doi: 10.1016/S0140-6736(18)31131-0.

  35. ISCHEMIA research group: Maron DJ, Hochman JS, ReynoldsHR, Bangalore S, O'Brien SM, Boden WE, et al. Initialinvasive or conservative strategy for stable coronary disease.N Engl J Med 2020; 382 (15): 1395-1407. DOI: 10.1056/NEJMoa1915922.

  36. McFalls EO, Ward HB, Moritz TE, Goldman S, Krupski W,Littooy F, et al. Coronary-artery revascularization beforeelective major vascular surgery. N Engl J Med 2004; 351(27): 2795-2804. DOI: 10.1056/NEJMoa041905.

  37. National Guideline Centre (UK). Preoperative Tests (Update):Routine Preoperative Tests for Elective Surgery.London: National Institute for Health and Care Excellence(UK); 2016 Apr. (NICE Guideline, No. 45.) Disponible en:https://www.ncbi.nlm.nih.gov/books/NBK355755/.

  38. Qaseem A, Snow V, Fitterman N, Hornbake ER, LawrenceVA, Smetana GW, et al. Clinical Efficacy Assessment Subcommitteeof the American College of Physicians. Riskassessment for and strategies to reduce perioperativepulmonary complications for patients undergoing noncardiothoracicsurgery: a guideline from the American Collegeof Physicians. Ann Intern Med 2006; 144 (8): 575-80. doi:10.7326/0003-4819-144-8-200604180-00008.

  39. Ayas NT, Laratta CR, Coleman JM, Doufas AG, Eikemann M,Gay PC, et al. Knowledge gaps in the perioperative managementof adults with obstructive sleep apnea and obesityhypoventilation syndrome. An official American ThoracicSociety Workshop report. Ann Am Thorac Soc 2018; 15 (2):117-126. doi: 10.1513/AnnalsATS.201711-888WS.

  40. Sessler DI, Bloomstone JA, Aronson S, Berry C, Gan TJ,Kellum JA, et al. Perioperative Quality Initiative consensusstatement on intraoperative blood pressure, risk andoutcomes for elective surgery. Br J Anaesth 2019; 122 (5):563-574. doi: 10.1016/j.bja.2019.01.013.

  41. Sudhakaran S, Surani SR. Guidelines for perioperativemanagement of the diabetic patient. Surg Res Pract 2015;2015: 284063. doi: 10.1155/2015/284063.

  42. Simha V, Shah P. Perioperative glucose control in patientswith diabetes undergoing elective surgery. JAMA 2019; 321(4): 399-400. doi:10.1001/jama.2018.20922.

  43. Meersch M, Schmidt C, Zarbock A. Patient with chronicrenal failure undergoing surgery. Curr Opin Anesthesiol2016; 29: 413-420. doi: 10.1097/ACO.0000000000000329.

  44. Northup PG, Friedman LS, Kamath PS. AGA Clinical practiceupdate on surgical risk assessment and perioperativemanagement in cirrhosis: Expert Review. Clin GastroenterolHepatol 2019; 17 (4): 595-606. DOI:https://doi.org/10.1016/j.cgh.2018.09.043.

  45. Palace MR. Perioperative management of thyroid dysfunction.Health Serv Insights 2017; 10: 1178632916689677.doi: 10.1177/1178632916689677.

  46. Wijeysundera DN, Duncan D, Nkonde-Price C, Virani SS,Washam JB, Fleischmann KE, et al; ACC/AHA Task ForceMembers. Perioperative beta blockade in noncardiacsurgery: a systematic review for the 2014 ACC/AHAguideline on perioperative cardiovascular evaluationand management of patients undergoing noncardiacsurgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines.Circulation 2014; 130 (24): 2246-64. doi: 10.1161/CIR.0000000000000104.

  47. Kahn SR, Diendere G, Morrison DR, Piché A, Filion KB,Klil-Drori AJ, et al. Effectiveness of interventions for theimplementation of thromboprophylaxis in hospitalizedpatients at risk of venous thromboembolism: an updatedabridged Cochrane systematic review and meta-analysisof randomized controlled trials. BMJ Open 2019; 9: 1-15.doi: 10.1136/bmjopen-2018-024444.

  48. Venous thromboembolism in over 16s: reducing the riskof hospital-acquired deep vein thrombosis or pulmonaryembolism. NICE guidelines. Consultado 16/11/2019. Disponibleen: www.nice.org.uk/guidance/ng89.

  49. Felder S, Schnack-Rasmussen M, King R, Sklow B, KwaanM, Madoff R, et al. Prolonged thromboprophylaxis withlow molecular wight heparin for abdominal or pelvicsurgery. Cochrane Database Syst Rev 2019; 8: 1-45. doi:10.1002/14651858.CD004318.pub2.




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