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E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy

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Pre-Operative Comprehensive Health Assessments for Children with Medical Complexity Undergoing Major Surgery.

Juliana Mariani¹, Jay G Berry²

¹Pediatric Intermediate Care Unit, Division of Medical Critical Care, Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.

Pediatric Clinics of North America

|April 22, 2026

Summary

This summary is machine-generated.

Children with medical complexity (CMC) face high surgical risks. A preoperative comprehensive health assessment (PreopCHA) identifies and mitigates these risks, improving surgical outcomes for pediatric patients.

Keywords:

Children with medical complexity Comprehensive health assessment Perioperative care Surgery

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E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy

Published on: August 1, 2019

Area of Science:

Pediatric Surgery
Complex Care Medicine
Perioperative Medicine

Background:

Children with medical complexity (CMC) have the highest risk of postoperative complications and prolonged recovery.
Surgery can optimize health and function in CMC, but requires careful risk management.
Existing approaches may not fully address the multifaceted needs of CMC undergoing surgery.

Purpose of the Study:

To highlight the critical importance of the preoperative comprehensive health assessment (PreopCHA) for CMC.
To outline the essential components of a PreopCHA.
To provide suggestions for implementing PreopCHA in clinical practice.

Main Methods:

The article synthesizes current knowledge on perioperative care for CMC.
It details the structure and scope of a comprehensive health assessment.
It discusses strategies for risk factor identification and mitigation prior to surgery.

Main Results:

PreopCHA allows for early detection and management of potential perioperative risks.
A thorough assessment considers medical, functional, social, and treatment-related factors.
Proactive risk mitigation can lead to safer surgical experiences and better recovery.

Conclusions:

Preoperative comprehensive health assessment (PreopCHA) is essential for optimizing surgical outcomes in children with medical complexity (CMC).
Implementing PreopCHA enables proactive management of perioperative risks, reducing complications and improving recovery.
This structured approach is paramount for the safe and effective surgical care of CMC.