Preoperative evaluation

[Lanell]

Before elective surgical procedures, a thorough preoperative medical evaluation by nonsurgical consultants (eg, internists, cardiologists, pulmonologists) may be necessary to help assess surgical risk. Such consultants may also help manage preexisting disease (eg, diabetes) and help prevent and treat perioperative and postoperative complications (eg, cardiac, pulmonary, infectious). Psychiatric consultation is occasionally needed to assess capacity or help deal with underlying psychiatric problems that can interfere with recovery.
Elderly patients may benefit from involvement of an interdisciplinary geriatric team, which may need to involve social workers, therapists, ethicists, and other practitioners.
If an emergency procedure is required (eg, for intra-abdominal hemorrhage, perforated viscus, necrotizing fasciitis), there is usually no time for a full preoperative evaluation. However, the patient