The definition of risk in surgical patients is a complex process mainly based on subjective evaluation of the patient’s overall health status by the surgeon and the anaesthesiologist and the type and urgency of the surgical procedure. An objective assessment of risk is essential to guide surgical decision-making, communication within the multidisciplinary team and with the patient and his family, allocation of resources, and improvement of patient outcomes through tailored perioperative care. Different risk prediction tools described in this chapter can be used in the evaluation of surgical risk; in addition, functional capacity, frailty, and the likelihood of perioperative neurocognitive disorders must be taken into account during risk assessment. Accurate and timely identification of high-risk surgical patients, defined by predicted hospital mortality of ≥5%, is required for optimizing their care through improved preoperative evaluation and perioperative management, including advanced haemodynamic monitoring and goal-directed haemodynamic optimization. This chapter aims to summarize the recent advances in perioperative risk stratification, suggesting a practical approach to the assessment of surgical risk.
Rovati, L., Arlati, S., Aseni, P. (2023). Defining the High-Risk Surgical Patient. In P. Aseni, A.M. Grande, A. Leppäniemi, O. Chiara (a cura di), The High-Risk Surgical Patient (pp. 3-7). Springer International Publishing [10.1007/978-3-031-17273-1_1].
Defining the High-Risk Surgical Patient
Rovati L.
Primo
;
2023
Abstract
The definition of risk in surgical patients is a complex process mainly based on subjective evaluation of the patient’s overall health status by the surgeon and the anaesthesiologist and the type and urgency of the surgical procedure. An objective assessment of risk is essential to guide surgical decision-making, communication within the multidisciplinary team and with the patient and his family, allocation of resources, and improvement of patient outcomes through tailored perioperative care. Different risk prediction tools described in this chapter can be used in the evaluation of surgical risk; in addition, functional capacity, frailty, and the likelihood of perioperative neurocognitive disorders must be taken into account during risk assessment. Accurate and timely identification of high-risk surgical patients, defined by predicted hospital mortality of ≥5%, is required for optimizing their care through improved preoperative evaluation and perioperative management, including advanced haemodynamic monitoring and goal-directed haemodynamic optimization. This chapter aims to summarize the recent advances in perioperative risk stratification, suggesting a practical approach to the assessment of surgical risk.
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