Preoperative Risk Assessment
What is a preoperative risk assessment?
Patients undergo a preoperative risk assessment before elective surgery. An elective surgery is a procedure which isn’t medically necessary, but still requires general and/or regional anesthesia. The assessment is performed so that any patient-specific risks can be identified and minimized. These risks include cardiac, pulmonary and infectious complications. From routine tests to individualized investigations, Dr Tony Tom offers comprehensive preoperative risk assessments to patients who have been advised of their option for surgery and are seeking help and advice in this regard.
Risk assessment in adults usually involves taking a patient's full medical history - including the events leading up to the surgery - and performing a physical examination, and based on this feedback considering which subsequent supporting tests or studies are required. Further testing beyond the history-taking and basic physical examination is not always necessary as they are the strongest predictors of perioperative complications. Sometimes though new medical issues are discovered in the process, and surgery is postponed until the issue can be stabilized.
Dr Tom will not order unnecessary tests. Additional tests are indicated on an individual basis if the history and physical examination indicates the presence of significant evidence for concern or if a disease may be present. Laboratory testing should be performed only if relevant organ disease is known or suspected, or to assess the potential side effects of drug therapies. Studies suggest using electrocardiography as a screening test seems to add very little relevant information, even in patients with stable heart disease. A chest X-ray will only be obtained if a disease is suspected whose detection would have clinical consequences in the perioperative period. Advanced age is a risk factor when it comes to surgery but not, in itself, a reason for ancillary testing.
These days, because making money has become so important and time is always considered short, preoperative evaluations have been falling by the wayside. But Dr Tony Tom believes that it is an important service to deliver to his patients. Preoperative assessment lowers and manages health risks, and because the patient is more informed and more aware of their situation they can advocate for themselves when dealing with the other specialists who are treating them and performing their procedure or surgery.