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Defining the High-Risk Surgical Patient

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The High-risk Surgical Patient

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Abstract

The definition of risk in surgical patients is a complex process mainly based on subjective evaluation of the patient’s overall health status by the surgeon and the anaesthesiologist and the type and urgency of the surgical procedure. An objective assessment of risk is essential to guide surgical decision-making, communication within the multidisciplinary team and with the patient and his family, allocation of resources, and improvement of patient outcomes through tailored perioperative care. Different risk prediction tools described in this chapter can be used in the evaluation of surgical risk; in addition, functional capacity, frailty, and the likelihood of perioperative neurocognitive disorders must be taken into account during risk assessment. Accurate and timely identification of high-risk surgical patients, defined by predicted hospital mortality of ≥5%, is required for optimizing their care through improved preoperative evaluation and perioperative management, including advanced haemodynamic monitoring and goal-directed haemodynamic optimization. This chapter aims to summarize the recent advances in perioperative risk stratification, suggesting a practical approach to the assessment of surgical risk.

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Author information

Authors and Affiliations

  1. School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy

    Lucrezia Rovati

  2. Emergency Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Lucrezia Rovati

  3. Intensive Care Unit “G. Bozza”, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Sergio Arlati

  4. Dipartimento di Emergenza Urgenza, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Paolo Aseni

  5. Department of Biomedical and Clinical Sciences “L. Sacco”, Università degli Studi di Milano, Milan, Italy

    Paolo Aseni

Authors
  1. Lucrezia Rovati
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  2. Sergio Arlati
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  3. Paolo Aseni
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Corresponding author

Correspondence to Lucrezia Rovati .

Editor information

Editors and Affiliations

  1. Dipartimento di Emergenza Urgenza, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Paolo Aseni

  2. Divisione di Cardiochirurgia, IRCCS Fondazione Policlinico San Matteo, Pavia, Pavia, Italy

    Antonino Massimiliano Grande

  3. Div. of Emerg. Surg., Abdominal Center, Helsinki University Hospital Meilahti, Helsinki, Finland

    Ari Leppäniemi

  4. Department of Pathophysiology and Transplantation, General Surgery and Trauma Team, University of Milano, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy

    Osvaldo Chiara

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Rovati, L., Arlati, S., Aseni, P. (2023). Defining the High-Risk Surgical Patient. In: Aseni, P., Grande, A.M., Leppäniemi, A., Chiara, O. (eds) The High-risk Surgical Patient. Springer, Cham. https://doi.org/10.1007/978-3-031-17273-1_1

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  • DOI: https://doi.org/10.1007/978-3-031-17273-1_1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-17272-4

  • Online ISBN: 978-3-031-17273-1

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