Preoperative Evaluation

Abstract

In every preoperative surgical patient we must evaluate heart, lung, and kidney function; in older adults we must also evaluate overall functionality, cognition, frailty, nutrition, polypharmacy, and social support. Understanding these domains and their impact on a patient are fundamental to helping optimize surgical outcomes. Although comprehensive “geriatric screening” may not always be a feasible option in some clinical settings, alternatives exist for more limited geriatric preoperative assessments. Performing a limited preoperative assessment can still allow surgeons to optimize and tailor planned procedures to reflect unique patient needs. A preoperative geriatric assessment allows the surgeon to preemptively decide involvement of nutrition, occupational therapy, physical therapy, social work, and other vital members of the postoperative care team. Furthermore, a preoperative geriatric assessment provides all members of the patient’s health-care team a clear understanding of a patient’s preoperative baseline.