Surgery Book

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Preoperative Pulmonary Risk Stratification

Aka: Preoperative Pulmonary Risk Stratification, Perioperative Pulmonary Complication Risk Factors
  1. See Also
    1. Preoperative Examination
    2. Preoperative Cardiovascular Evaluation
    3. Preoperative Evaluation in Kidney Disease
    4. Perioperative Beta Blocker
    5. Antiplatelet Therapy for Vascular Disease
    6. Perioperative Cardiovascular Risk
    7. Perioperative Diabetes Management
    8. Deep Vein Thrombosis Prevention
    9. Perioperative Anticoagulation
    10. Endocarditis Prophylaxis
    11. Postoperative Nausea and Vomiting Prevention
    12. Perioperative Corticosteroid
    13. Preoperative Guidelines for Medications Prior to Surgery
  2. Indications
    1. Informed Consent regarding pulmonary surgical risk for elective non-cardiac surgery
      1. Review with patient if benefits of procedure outweigh risks
  3. Risk Factors: Perioperative Pulmonary Complication Risk Factors by Patient Factors (Odds Ratio)
    1. Current Smoking: 1.4
    2. American College of Anesthesiologists (ASA) Class II or higher: 4.87
    3. Congestive Heart Failure: 2.93
    4. Chronic Obstructive Pulmonary Disease (COPD): 2.3
    5. Age over 60 years old: >2.28
    6. Unable to complete Activities of Daily Living (ADLs) without assistance or Assistive Devices: >1.65
    7. Serum Albumin <3.5 mg/dl
  4. Risk Factors: Perioperative Pulmonary Complication Risk Factors by Surgery (Odds Ratio)
    1. Aortic aneurysm repair: 6.9
    2. Thoracic Surgery: 4.24
    3. Abdominal surgery: 3.09
    4. Neurosurgery: 2.53
    5. Emergency surgery: 2.52
    6. General anesthesia: 2.35
    7. Prolonged surgery >3 hours: 2.26
    8. Head and neck surgery: 2.21
    9. Vascular surgery: 2.10
  5. References
    1. Dummer (2009) Perioperative Guideline Review
    2. Smetana (2006) Ann Intern Med 144(8):581-95 [PubMed]

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