Preoperative risk assessment in vascular surgery patients

• The patient scheduledf or peripheral vascular surgery is an increaseda naestheticc hallenge, mainly because of coexisting generalized cardiovascular atherosclerotic involvement leading to a high risk of perioperative cardiac complications. In clinical practice it is of importance preoperatively to predict, as accurately as possible, the potential risk of complications so that proper risk-reducing measures can be taken. Relevant clinical data, which have been included by Goldman and Detsky in multifactorial cardiac risk indices, are of potential value for differentiating between patients at low, intermediate, or high risk of perioperative cardiac morbidity and mortality. Patients with low risk scores can be accepted for surgery without further testing, thereby allowing more extensive cardiac testing, such as ambulatory ECG monitoring, exercise stresst esting, echocardiography,d ipyridamole thallium imaging, or coronary angiography,t o be reserved for patients with higher risk scores or overt cardiac problems. The risk stratification is of importance not only for decisions on preoperative prophylactic therapeutic measures (e.g. optimization of medical therapies, coronary artery revascularization), but also for decisions on intraoperative anaesthetic management and postoperative care

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)

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