Preoperative medical consultation: maximizing its benefits

• Published in: The American journal of surgery 2012-11, Vol.204 (5), p.787-797
• Main Authors: Rivera, Raul A., M.D., F.A.C.P, Nguyen, Mai T., M.D., F.A.C.P, Martinez-Osorio, Jorge I., M.D, McNeill, Matthew F., M.D, Ali, Sayed K., M.D, Mansi, Ishak A., M.D., F.A.C.P
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Cardiovascular disease; Comorbidity; Consultation; Elective Surgical Procedures; General aspects; General Surgery; Health participants; Health Status Indicators; Heart attacks; Humans; Intraoperative Complications - prevention & control; Medical; Medical consultation; Medical sciences; Mortality; Postoperative Complications - prevention & control; Practice Guidelines as Topic; Preoperative; Preoperative Care - methods; Preoperative consultation; Preoperative medical consultation; Psychotropic drugs; Public health. Hygiene; Public health. Hygiene-occupational medicine; Referral and Consultation; Risk Assessment; Surgery
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2012.02.018

Abstract Background The increasing complexity of medical and surgical care often demands comprehensive preoperative work-ups by medical consultants and detailed management recommendations to optimize the patient's medical ailments before surgery. This article aims to review the available evidence and discuss elements of the preoperative medical consultation that are of particular relevance to surgeons. Methods The authors performed a comprehensive review of the available medical literature and guidelines pertaining to preoperative medical management and present a narrative summary of their findings. Results Although many preoperative recommendations are based on expert opinion and consensus, a growing number of studies and clinical practice guidelines provides direction as to what is the best management of patients with medical problems before surgery. Conclusions Collaborative efforts and adequate communication between the medical and surgical teams are necessary to ensure appropriate patient management before surgery. Although higher-risk patients may require thorough preoperative evaluations, extensive routine investigations may not always be necessary.