Pre-operative medical complications in patients admitted to hospital for elective orthopaedic surgery

At the Royal National Orthopaedic Hospital (RNOH) between 1 November 1981 and 31 October 1982 3,628 operations were performed and 96 patients were referred preoperatively to a physician for clinical assessment of their fitness to withstand the operation. In 36 of these patients the operation was postponed because of medical complications and in 6 it was cancelled. The commonest reason for postponement was uncontrolled hypertension (16 patients). It is likely that 24 (67%) of the 36 postponements could have been avoided if arrangements had existed to record the blood pressure, pulse rate, haemoglobin level and urinalysis of each patient at the time of initial hospital attendance.