Preoperative Evaluation

Preoperative Evaluation

1. Age-related coexisting disease is a major predictor for perioperative mortality and serious morbidity. Age-related coexisting disease increases elderly patients' risks for perioperative events such as:
   1. Myocardial infarction
   2. Congestive heart failure
   3. Delirium
   4. Stroke
   5. Aspiration and pneumonia
   6. Sepsis
   7. Adverse drug reactions
   8. Falls
   9. Pressure sores
2. Age alone is a minor predictor for perioperative complications.
3. Assessment of health and functional status. A detailed history and physical examination are required, with emphasis on physical condition, ambulation, activities of daily living, preoperative living situation, and preexisting disabilities.
4. Preoperative testing. Testing should be based on coexisting disease and recommended guidelines (see Chapter 1). Recommended testing in elderly patients includes electrocardiogram, chest radiograph, complete blood count, electrolyte panel that includes blood urea nitrogen, creatinine, potassium (especially if the patient is receiving a diuretic), and glucose.