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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
PubMed

Insights

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.

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.

Keywords:
Children with medical complexityComprehensive health assessmentPerioperative careSurgery

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