Tools and scores for perioperative pulmonary, renal, hepatobiliary, hematological, and surgical site infection risk assessment: an update

Abstract

Introduction: perioperative risk assessment is essential to mitigate surgical complications, which suggests individual and collective interest since the number of surgical procedures in Brazil has been expanding steadily. The aim of this study was to summarize and detail the main calculators, indexes and scores regarding perioperative pulmonary, renal, hepatobiliary, hematological and surgical site infection risks for general non-cardiac surgeries, which are dispersed in the literature. Method: a narrative review was performed based on manuscripts in English and Portuguese found in the electronic databases Pubmed/MEDLINE and EMBASE. Results: the review included 11 tools related to the systems covered, for which the application method and its limitations are detailed. Conclusion: the non-cardiovascular perioperative risk estimation tools are beneficial when disturbances are identified in the preoperative clinical examination that justify a possible increased risk to the affected system, so the use of these tools provides palpable values to aid in the judgment of surgical risk and benefit as well as it identifies factors amenable to intervention to improve outcomes.

Preoperative risk evaluation and optimization for patients with liver disease

“…Of these, acute viral hepatitis, AH, and ALF have been identified as contraindications for elective surgery [ 25 , 26 ]. For these reasons, it is recommended that any non-urgent operative intervention should be postponed until resolution or treatment [ 25 , 27 ]. However, there is a notable lack of research in this area, and the evidence supporting current recommendations predates modern diagnostic practices, surgical techniques, and medical management.…”