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Preoperative medical evaluation of the adult healthy patient

Gerald W Smetana, MD
Section Editors
Andrew D Auerbach, MD, MPH
Natalie F Holt, MD, MPH
Deputy Editor
Daniel J Sullivan, MD, MPH


Clinicians are often asked to evaluate a patient prior to surgery. The medical consultant may be seeing the patient at the request of the surgeon or may be the primary care clinician assessing the patient prior to consideration of a surgical referral. The goal of the evaluation of the healthy patient is to detect unrecognized disease and risk factors that may increase the risk of surgery above baseline and to propose strategies to reduce this risk.

The evaluation of healthy patients prior to surgery is reviewed here. Preoperative assessments for specific systems issues and surgical procedures are discussed separately. (See "Evaluation of cardiac risk prior to noncardiac surgery" and "Perioperative medication management" and "Overview of the principles of medical consultation and perioperative medicine" and "Evaluation of preoperative pulmonary risk" and "Cataract in adults", section on 'Preoperative medical evaluation'.)


In general, the overall risk of surgery is extremely low in healthy individuals. Therefore, the ability to stratify risk by commonly performed evaluations is limited.

Screening questionnaire — Screening questions appear on many standard institutional preoperative evaluation forms. One validated screening instrument, derived from 100 patients, comprises 17 questions that allowed nurses to identify those patients who would benefit from a formal preoperative evaluation by an anesthesiologist (table 1) [1]. The questions chosen for this questionnaire were devised to detect preexisting conditions shown to be associated with perioperative adverse events.

Age — A number of commonly employed and validated indices consider age as a minor component of preoperative coronary risk. (See "Evaluation of cardiac risk prior to noncardiac surgery".)

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Literature review current through: Nov 2017. | This topic last updated: Aug 04, 2017.
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