PREOPERATIVE CLINICAL-EVALUATION

The purpose of preoperative evaluation is to reduce the morbidity and mortality of surgical interventions. The operative risk is related to: the nosocomial environment, the anesthetic procedure, the surgical te am, the magnitude of the intervention and the patient's psychological, physical and pathological conditions. An adequate history and physica l examination are essential to evaluate the patient's clinical situati on, In our country, an electrocardiogram (EKG) with an estimation of t he ''surgical risk'' and a number of laboratory tests are usually done . This article discusses the evidence and recommendations on the usefu lness and indications of the EKG, the laboratory test, the coagulation tests and the chest X-ray. The decision to order preoperative tests s hould be based an positive clinical findings, the need to obtain basal values before major interventions and the existence of risk factors f or certain diseases. The ambulatory preoperative clinical evaluation i s the best method for the detection of diseases that could modify the surgical risk. It is also the opportunity to consult specialists if ne eded and to indicate necessary prophylactic measures.