Patient’s Own Risk Factors

  • Shadi Dowlatshahi
  • Wei-I Vickie Wu
  • Michael Donald Wang
Chapter

Abstract

Successful robotic surgery requires preoperative medical optimization. Best practice addresses the spectrum of the patient’s own medical risk factors in an effort to identify patients with elevated risk and ascertain what is modifiable. This spectrum includes cardiac and pulmonary issues, as well as thromboembolic and bleeding risk. Because robotic surgery is often performed in older patients, we also discuss delirium and frailty. In this chapter we cover risk factors, risk assessment tools, and interventions that may improve outcomes, in addition to reviewing procedure-related medical complications. Our aim is to provide a solid medical approach to a smooth operation.

Keywords

Preoperative risk assessment Clinical risk predictors Risk factors Cardiac risk Pulmonary risk Bleeding risk Delirium Frailty 

Abbreviations

ABG

Arterial blood gas

AC

Anticoagulation

ACEI

Angiotensin-converting enzyme inhibitor

ACS-NSQIP

American College of Surgeons National Surgical Quality Improvement Program

ACS-NSQIP MICA

ACS-NSQIP Gupta MI Cardiac Arrest

AP

Antiplatelet

ARB

Angiotensin receptor blocker

ASA

American Society of Anesthesiology

ASA

Aspirin

BMS

Bare-metal stent

CABG

Coronary artery bypass graft

CAM

Confusion Assessment Method

COPD

Chronic obstructive pulmonary disease

CPAP

Continuous positive airway pressure

CrCl

Creatinine clearance

DAPT

Dual antiplatelet therapy

DES

Drug-eluting stent

DOAC

Direct oral anticoagulant

DSE

Dobutamine stress echocardiogram

DVT

Deep vein thrombosis

IOP

Intraocular pressure

IS

Incentive spirometry

LMWH

Low molecular weight heparin

MACE

Major adverse cardiac event

METS

Metabolic equivalents

MI

Myocardial infarction

MPH

Miles per hour

MPI

Myocardial perfusion imaging

NGT

Nasogastric tube

OSA

Obstructive sleep apnea

PCI

Percutaneous coronary intervention

PE

Pulmonary embolism

PFTs

Pulmonary function tests

PPCs

Postoperative pulmonary complications

RCRI

Revised Cardiac Risk Index

UFH

Unfractionated heparin

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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Shadi Dowlatshahi
    • 1
  • Wei-I Vickie Wu
    • 2
  • Michael Donald Wang
    • 3
  1. 1.Department of Internal MedicineOregon Health and Science UniversityPortlandUSA
  2. 2.Department of MedicineUniversity of Southern CaliforniaLos AngelesUSA
  3. 3.Department of MedicineKeck Medical Center of University of Southern CaliforniaLos AngelesUSA

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