How is surgical risk assessed during perioperative cardiac management?

Updated: Feb 04, 2019
  • Author: Davinder Jassal, MD; Chief Editor: William A Schwer, MD  more...
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Answer

Answer

The clinician must consider 2 factors when assessing the patient's cardiovascular risk: (1) the type of surgery, and (2) the hemodynamic stress associated with the procedure. Generally, the more extensive the surgical procedure, the greater the physiological stress, the more significant the postoperative pain, and the greater the incidence of cardiac complications. Surgical operations may be classified as follows:

  • High risk (>5% rate of perioperative death or MI) - Emergent major operations (particularly in elderly patients), peripheral vascular or aortic surgery, and prolonged procedures with large amounts of blood loss involving the abdomen, thorax, head, and neck

  • Intermediate risk (1-5% rate of perioperative death or MI) - Carotid endarectomy and urologic, orthopedic, uncomplicated abdominal, head, neck, and thoracic operations

  • Low risk (< 1%) - Cataract removal, endoscopy, superficial procedure, and breast surgery


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