Preoperative evaluation: pulmonary, cardiac, renal dysfunction and comorbidities.
This article reviews evidence supporting the exercise of risk assessment and demonstrates how it assists in determining which patients should undergo a planned invasive procedure. The article focuses on the preoperative functional assessment of three major organ systems--cardiac, pulmonary, and renal--and reviews guide-lines for determining which patients need additional testing of organ system function. The article also discusses how to improve the condition of selected patients so that the surgeon can achieve the best possible result and outcome.
Joehl
Raymond J
RJ
Loyola University Medical Center, 2160 South First Avenue, Maywood, IL 60153, USA. raymond.joehl@med.va.gov
D015897:Comorbidity; D005069:Evaluation Studies as Topic; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis / Q000453:epidemiology*; D006334:Heart Function Tests; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000453:epidemiology*; D007677:Kidney Function Tests; D008107:Liver Diseases / Q000175:diagnosis / Q000453:epidemiology*; D008111:Liver Function Tests; D008171:Lung Diseases / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D018579:Patient Selection; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods*; D012129:Respiratory Function Tests; D018570:Risk Assessment; D013514:Surgical Procedures, Operative / Q000592:standards* / Q000639:trends; D016896:Treatment Outcome