Prolonged anesthesia times of 8 hours or more, a history of hepatitis, and large-volume intraoperative fluid resuscitations predicted adverse outcomes. Special care must be taken in counseling these patients preoperatively and in caring for them during their operative and postoperative course.

Self-reported exercise tolerance can be used to predict in-hospital perioperative risk, even when using relatively simple and familiar measures.

No abstract

The US spends more money than any other country in the world on health care but does not have the best health outcomes. Most healthcare dollars are spent on treatment of preventable chronic conditions including heart disease, hypertension, diabetes, hypertension, and obesity. Many recent studies have shown that a poor diet and low cardiorespiratory fitness are associated with significant morbidity and an increased risk of all-cause mortality. There is evidence that those with higher cardiorespiratory fitness have lower annual healthcare costs. Despite continued research on the essential role of diet and exercise in optimal health, these vital health behaviors have been slow to change in the US population and do not receive adequate attention. We propose more objective screening, visible and monitored in the Electronic Health Record, to improve awareness, help educate patients, and monitor their progress over time. It would also help identify those individuals that would benefit from referral to interventional behavioral resources in the clinic and community. With an increased focus on preventive and population health measures, now is an ideal time to include both exercise and diet in health metrics. A few relatively simple changes could prompt providers to assess and educate patients about nutrition and fitness and promote a healthier population.