Surgical risk is a form of assessment of the clinical and medical status of the person undergoing surgery, so that risks and complications are identified during the previous period, during and. after surgery.
This risk is calculated by clinical evaluation of the physician and the request of some exogenous students. In addition, there are some protocols that better guide medical reasoning, such as ASA, Lee, and ACP for example.
- Any doctor can make this assessment.
- But in general is chosen by the GP.
- Cardiologist or anaesthetist.
- In this way special care can be given to each person before the intervention.
- Such as requesting inappropriate examples or performing treatments to reduce the risk.
Pre-surgical medical evaluation is very important to define what type of surgery could be performed on each person and determine if the risks outweigh the benefits. The evaluation includes:
The clinical examination is carried out with the collection of personal data, such as the drugs in use, the symptoms, the diseases you may have, in addition to the physical assessment, such as cardiac and pulmonary auscultation.
From clinical evaluation, it is possible to obtain the first form of risk classification, created by the American Society of Anesthesiologists, known as ASA:
Most can be the number of ASA ratings, it can be the risk of death and complications due to surgery, depending on the type of surgery that is worth performing and what is most beneficial to the person.
Knowing the type of surgical procedure that will be performed is also very important, as it is more complex and important in surgery, the greater the risks that the person can undergo and greater care to take.
In this way, types of surgery can be categorized based on the risk of heart complications, such as:
Endoscopic procedures, such as endoscopy, colonoscopy;
Surface surgeries, such as skin, breasts, eyes.
Surgery of the chest, abdomen of the prostate;
The surgeon chief neck;
Orthopedic surgeries, such as a fracture;
Correction of abdominal aortic aneurysms or removal of carotid thrombus.
Major emergency surgeries;
Surgery of large blood vessels, such as aorta or carotid, for example.
There are algorithms that more effectively manage the risk of complications and changes in heart surgery, in order to study the clinical situation of the person and certain examples.
Some examples of algorithms used in Goldman’s cardiac risk index, Lee’s revised cardiac risk index, and the American College of Cardiology (ACC) algorithm. To calculate risk, consider certain personal data, such as:
From the data obtained, surgical risk can be determined, so if the risk is low, surgery is possible, on the other hand, if the risk is medium high, your doctor can give advice, get the type of surgery, or ask for more tests to help assess the best risk. surgical character.
Preoperative examinations should be performed to look for any changes in the case of suspicion, which could lead to a surgical complication, so it is not necessary to ask for the same myths for everyone, but there is no evidence that they help reduce complications. For example, in persons without symptoms, with low surgical risk and who will undergo low-risk surgery, there is no need for testing.
However, some of the most requested and recommended examples are usually:
Usually these tests are valid for 12 months, without having to repeat them during this period, however, in some cases, the doctor may find it necessary to repeat them earlier, so some doctors may also consider it important to request these tests. even for people without change.
Other tests, such as sponge distension, echocardiogram, or holter, may be required for certain types of surgery, but for people with heart disease.
Because of tests and tests, if the values are good, your doctor may schedule surgery or give directions to reduce the maximum risk of complications from surgery.
In this way, your doctor may recommend other more specific tests, adjusting doses or introducing certain medications, assessing the need to correct heart function through surgery, directing physical activity, losing weight or quitting smoking, among others.