Surgical Risk Assessment

Risk comes from not knowing what you’re doing. Warren Buffett

I

1.
Whether it is a life-saving liver transplant or a cosmetic procedure, surgical intervention offers some benefit to the patient, at the risk of complications, morbidity, or even death. The surgeon must carefully weigh the relative risks and benefits of surgery before proceeding with any operation. Perioperative care requires the identification and reduction of risk factors, whether due to the patient or inherent to the operation itself.
2.
Determination of risks and benefits requires careful consideration of the following factors:
- a.
  Disease process
  - (1)
    Natural course if left untreated
  - (2)
    Medical versus surgical treatment options
- b.
  Medical therapy
- c.
  Surgical therapy
  - (1)
    Indications and contraindications
  - (2)
    Risk factors related to surgical intervention
  - (3)
    Technical aspect of the operation
  - (4)
    Logistical limitations
  - (5)
    Potential for complications
  - (6)
    Urgency of operation
- d.
  Patient factors
  - (1)
    Physiologic reserve
  - (2)
    Risk factors related to medical comorbidities
  - (3)
    Reducing operative risk
- e.
  Preoperative care
- f.
  Postoperative management

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