Preoperative Risk Assessment

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Preoperative risk assessment is an essential requirement before performing any planned surgical procedure. It will reduce the risk factors and complications that might arise during and after the procedure. Board Certified Internal Medicine Physicians Dr. Aldo Arpaia and Dr. Bart Savino provide complete evaluation and assessment in order to ensure you meet health condition guidelines before surgery.

What are the benefits of preoperative risk assessment?
· Reduce all possible risk factors before surgical procedure
· In-depth assessment and evaluation

Why Choose Dr. Arpaia and Dr. Savino for preoperative risk assessment?
Dr. Arpaia and Dr. Savino are experts in the field of preoperative medical consultation. They provide comprehensive assessment services to identify each patient’s specific risk factors before surgery.  They are also equipped to treat patients and help eliminate some of these risk factors prior to surgery to achieve more effective results. They also follow you throughout the pre-operative and post-operative period.
Contact us if you are contemplating or scheduled for surgery to address any needs and concerns.

What is preoperative risk assessment?
Preoperative risk assessment is a specialized office visit to assess patient’s health, durability and operative risk for a planned procedure. It involves care of patient from the time considered for surgery to the time immediately before the operation. It deals with all general issues, risk factors, examinations and routine tests before a patient goes in for a operation.

What are the goals of preoperative medical risk assessment?
· Identification of hidden conditions that might cause problem during and after surgery.
· Identification of important medical issues.
· Identification of important social issues which may impact planned procedure and recovery time period.
· Awareness to patient about planned procedure, anesthesia, intraoperative care and postoperative treatment.
· Optimization of patient’s treatment that reduces patient’s mortality factor before surgical and anesthetic procedures.

What are the components of preoperative risk assessment?
The major component of preoperative risk assessment is the general assessment, which further includes following components:

History:
It includes patient’s past and recent medical history, family history, surgical history, social history (use of drugs), history of drug therapy, allergies’ history, unusual reactions to medications , complications with previous anesthetics, recent infections and birth history (in children).

Physical examination:
It is centered on information gathered after history. The pre-anesthetic examination includes identification of common abnormalities of cardiovascular, respiratory, gastrointestinal and musculoskeletal system, airway assessment and documentation of vital signs.

Laboratory work:
The recommended lab tests are based on the information gathered from history and physical exam, patient age and complexity of surgical procedure.

History of medication:
The doctor will decide whether any medication should discontinue while considering the specific surgical procedure, risk of interaction with drugs used in anesthesia.

How preoperative risk assessment works:
A relatively simple system called American Society of Anesthesiologists Classification of Physical Status (ASA) is being widely used among a wide range of different preoperative risk stratification systems. It describes a physical state of the patient and correlates with surgical risks. It is useful and should apply to all patients for surgery. Increase in physical status is related with increase in mortality. A brief description of ASA system is as follows:
· Grade (I) – No physiological and psychological disturbance.
· Grade (II) – The disease does not interfere with normal activity.
· Grade (III) – The disease interferes or limits normal activity.
· Grade (IV) – A constant life-threatening disease.
· Grade (V) – Patient has no chances of survival for 24 hours.
· E – It is added to this system to indicate any emergency operation.
The preoperative work will be guided by the type of surgery proposed and fitness level of the patient.

Risk factors: The risk factors depend on the type of surgery. They are divided into 3 categories:
· Low risk – Minimum physiological risk to patient
· Medium risk – Moderate physiological risk to patient
· High risk – Significant preoperative physiological risk to patient

Assessing risk factors for cardiac and respiratory diseases:
Cardiac and respiratory diseases have specific relevant areas to receive preoperative care. The cardiorespiratory diseases should be treated before the surgery to minimize the possible risks. There are various stratification systems for cardiac disease which are used for preoperative cardiac risk assessment.
Book an appointment to see one of our award winning Internal medicine doctors by calling (718)-727-1898 or fill out contact form

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