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Preoperative Evaluation of the Noncardiac Surgical Patient

Andrew E. Grimes, MD and Stacy L. Jones, MD, FASA Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Preoperative medical evaluation should determine the presence of established or unrecognized disease or other factors that may increase the risk of perioperative morbidity and mortal...

DIAGNOSIS

HISTORY

  • Evaluate pertinent medical records and interview the patient. Many institutions provide standard patient questionnaires that screen for preoperative risk factors:

    • History of present il...

TREATMENT

MEDICATION

  • Reducing cardiac risk

    • Elective surgery should be delayed or cancelled if the patient has any of the following: unstable coronary syndromes (unstable or severe angina), recent MI (...

REFERENCES

1
Fleisher LA, Fleischmann KE, Auerbach AD, et al. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: executive summa...

ADDITIONAL READING

  • Akhtar S, Barash PG, Inzucchi SE, et al. Scientific principles and clinical implications of perioperative glucose regulation and control. Anesth Analg.  2010;110(2):478–497. [V...

CODES

ICD10

  • Z01.818 Encounter for other preprocedural examination

  • Z01.811 Encounter for preprocedural respiratory examination

  • Z01.812 Encounter for preprocedural laboratory examination

ICD9

  • V72.84 Pre-oper...

CLINICAL PEARLS

  • The preoperative evaluation should include medical record evaluation, patient interview, and physical exam.

  • The minimum for the physical exam includes airway, pulmonary, and cardiovascu...

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