Preoperative assessment - Primary care work-up to identify surgical risks

For many older patients, surgery is an inevitable component of healthcare. Thorough and effective preoperative patient evaluation is imperative becaus e comorbidities, polypharmacy, functional problems, and socio-economic issu es all can affect perioperative decisions and complicate recovery. A method ical assessment includes a history and physical exam, review of prescriptio n and nonprescription medications, evaluation of major organ systems, and d iscussion with the patient of advance directives. Other major consideration s include functional status, the risk level of the surgery to be performed, expected blood loss, and anesthesia duration. The primary care physician m ust synthesize and relay this patient data to the surgical team so that app ropriate measures can be taken to minimize perioperative risks and promote uncomplicated recovery.