[Reducing postoperative morbidity and mortality with preoperative risk evaluation and with refined perioperative medical care].
Reducing postoperative morbidity and mortality is important not only for patients' outcome but for reduction of financial burden on society. Precise and accurate preoperative evaluation of surgical risk factors is crucial to plan appropriate postoperative allocation of medical resources. American Society of Anesthesiologists physical status is a traditional measure to describe preoperative risk of patients undergoing surgery. In the last decade, several scoring systems with better sensitivity and specificity were reported and validated. Charlson Age-comorbidity Index, Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) are frequently used scoring systems. Several lines of evidence indicate that negligence of medical caregivers cause substantial numbers of errors to patients and often leads to severe complications or deaths. Full compliances to surgical checklists and implementation of medical team will help reduce these errors and lead to better patients' postoperative outcomes.
Department of Anesthesiology, Tokyo University Graduate School of Medicine, Tokyo 113-8655.
Kanji
K
Uchida
D006801:Humans; D019990:Perioperative Care; D011183:Postoperative Complications / Q000517:prevention & control*; D018570:Risk Assessment / Q000379:methods