Every surgical procedure carries some degree of risk which is influenced by the type of procedure being performed as well as the patient’s overall health going into the procedure. A careful history and physical exam can help assess the degree of risk associated with a procedure as well as identify potential ways to reduce risk. Conditions such as cardiovascular disease, kidney dysfunction, lung disease and liver disease can increase the risk associated with a surgery. Furthermore, insulin use, chronic immunosuppression, anticoagulation and antiplatelet medications can increase the risk of a surgery and certain adjustments may be needed prior to and immediately after surgery. Finally, certain lifestyle factors such as obesity, smoking or alcohol use can increase risk. In some situations, identifying elevated risk and further evaluating or potentially treating these factors can improve surgical outcomes. Ultimately, the first step is a thorough evaluation in the context of the procedure and anesthetic being considered.
Cohn S. In The Clinic: Preoperative Evaluation for Noncardiac Surgery. Ann Intern Med. 2016. Dec 6; 165(11)