[Preoperative cardiac assessment before non-cardiac surgery: cardiac risk stratification]

Area of Science:

• Cardiology
• Anesthesiology
• Internal Medicine

Context:

• Perioperative cardiac events are a significant cause of morbidity and mortality in patients undergoing non-cardiac surgery.
• Current guidelines emphasize an individualized approach to preoperative cardiac risk stratification.
• Risk assessment integrates patient-specific factors (cardiac conditions, clinical risk factors, functional capacity) and surgical factors.

Purpose:

• To outline the current recommendations for preoperative cardiac risk stratification and management in patients undergoing non-cardiac surgery.
• To highlight the importance of an individualized approach based on patient and surgical risk.
• To emphasize the role of preoperative cardiac investigations in select high-risk patients.

Summary:

• Perioperative cardiac events are common in non-cardiac surgery, necessitating careful risk assessment.
• Individualized risk stratification considers patient factors and surgical complexity.
• Preoperative cardiac investigations are reserved for high-risk patients to guide perioperative management.
• A multidisciplinary approach, including general practitioners, is crucial for developing personalized perioperative strategies.

Impact:

• Improved patient outcomes by reducing perioperative cardiac morbidity and mortality.
• More efficient utilization of preoperative cardiac investigations, focusing on high-risk individuals.
• Enhanced collaboration between healthcare providers for comprehensive patient care.
• Facilitation of evidence-based, individualized perioperative management plans.