Preoperative Evaluation for Major Noncardiac Surgery

Abstract

The number of patients undergoing major noncardiac surgery has steadily increased over the last decade. Cardiovascular complications are important and often feared by patients, surgeons, and anesthesiologists. Although preoperative risk assessment has improved since Goldman and colleagues published their landmark article that introduced the Multifactorial Index of Cardiac Risk 25 years ago, it continues to require modification, especially with the increasing prevalence of heart failure and the increase in procedures performed in the elderly. This review will summarize preoperative assessment and perioperative management with an emphasis on heart failure.

Prognostic Impact of Preoperative Left Ventricular Systolic Dysfunction in Older Adult Patients With Gastric Cancer

“…Previous studies have shown that heart failure is a significant risk factor for perioperative cardiac complications in noncardiac surgery ( 3 , 6 , 12 , 13 ). Thomas et al identified a history of heart failure as an independent predictor of surgical complications ( 3 ).…”

Prognostic Impact of Preoperative Left Ventricular Systolic Dysfunction in Older Adult Patients With Gastric Cancer

“…Previous studies have shown that heart failure is a significant risk factor for perioperative cardiac complications in noncardiac surgery ( 3 , 6 , 12 , 13 ). Thomas et al identified a history of heart failure as an independent predictor of surgical complications ( 3 ).…”

Risk factors for postoperative systemic complications in elderly patients with brain tumors

“…Various studies have investigated these general risk factors; whole blood Hb, serum TP, and serum albumin levels and natural killer cell activity are thought to reflect the patients' nutritional status. 4,15,16,29,31 However, potentially unique risk factors in elderly patients undergoing brain tumor surgery have not been examined; thus, the present study provides clinically very meaningful information. A low preoperative KPS score indicates undernutrition and reduced physiological immunity, which makes patients more vulnerable to infections.…”

Incidence, Outcomes, and Risk Factors for Preincision Cardiac Arrest in Cardiac Surgery Patients

“…In noncardiac surgery, congestive heart failure was an independent risk factor for perioperative events. 26,27…”

“…In noncardiac surgery, congestive heart failure was an independent risk factor for perioperative events. 26,27 We were not able to assess the induction agent as a risk factor, because etomidate prevailed as a choice of hypnotic in our patients with cardiac arrest. Other induction agents were rarely used in the event group.…”

Prognostic Impact of Preoperative Left Ventricular Systolic Dysfunction in Older Adult Patients With Gastric Cancer

“…Previous studies have shown that heart failure is a significant risk factor for perioperative cardiac complications in noncardiac surgery ( 3 , 6 , 12 , 13 ). Thomas et al identified a history of heart failure as an independent predictor of surgical complications ( 3 ).…”

Risk factors for postoperative systemic complications in elderly patients with brain tumors

“…Various studies have investigated these general risk factors; whole blood Hb, serum TP, and serum albumin levels and natural killer cell activity are thought to reflect the patients' nutritional status. 4,15,16,29,31 However, potentially unique risk factors in elderly patients undergoing brain tumor surgery have not been examined; thus, the present study provides clinically very meaningful information. A low preoperative KPS score indicates undernutrition and reduced physiological immunity, which makes patients more vulnerable to infections.…”

Incidence, Outcomes, and Risk Factors for Preincision Cardiac Arrest in Cardiac Surgery Patients

“…In noncardiac surgery, congestive heart failure was an independent risk factor for perioperative events. 26,27…”

“…In noncardiac surgery, congestive heart failure was an independent risk factor for perioperative events. 26,27 We were not able to assess the induction agent as a risk factor, because etomidate prevailed as a choice of hypnotic in our patients with cardiac arrest. Other induction agents were rarely used in the event group.…”

Prognostic Impact of Preoperative Left Ventricular Systolic Dysfunction in Older Adult Patients With Gastric Cancer

“…Previous studies have shown that heart failure is a significant risk factor for perioperative cardiac complications in noncardiac surgery ( 3 , 6 , 12 , 13 ). Thomas et al identified a history of heart failure as an independent predictor of surgical complications ( 3 ).…”

Risk factors for postoperative systemic complications in elderly patients with brain tumors

“…Various studies have investigated these general risk factors; whole blood Hb, serum TP, and serum albumin levels and natural killer cell activity are thought to reflect the patients' nutritional status. 4,15,16,29,31 However, potentially unique risk factors in elderly patients undergoing brain tumor surgery have not been examined; thus, the present study provides clinically very meaningful information. A low preoperative KPS score indicates undernutrition and reduced physiological immunity, which makes patients more vulnerable to infections.…”

Incidence, Outcomes, and Risk Factors for Preincision Cardiac Arrest in Cardiac Surgery Patients

“…In noncardiac surgery, congestive heart failure was an independent risk factor for perioperative events. 26,27…”

“…In noncardiac surgery, congestive heart failure was an independent risk factor for perioperative events. 26,27 We were not able to assess the induction agent as a risk factor, because etomidate prevailed as a choice of hypnotic in our patients with cardiac arrest. Other induction agents were rarely used in the event group.…”