The criteria of “inoperabilityâ€

https://doi.org/10.4081/monaldi.2017.851

Authors

  • Stefano Romagnoli | stefano.romagnoli@unifi.it Azienda Ospedaliero-Universitaria Careggi, Department of Anesthesiology and Intensive Care, Italy.
  • Laura Paparella Azienda Ospedaliero-Universitaria Careggi, Department of Anesthesiology and Intensive Care, Italy.
  • Paolo Boninsegni Azienda Ospedaliero-Universitaria Careggi, Department of Anesthesiology and Intensive Care, Italy.

Abstract

In the literature, the term “inoperable†mainly refers to two specific clinical aspects: cancer staging and technical difficulty/impossibility in performing. In light of this clarification, the statement “the patient cannot be anesthetized†has no medical foundation. On the contrary, the physicians have to carefully stratify the perioperative risk and optimize the patients’ preoperative clinical status. In order to perform a precise risk stratification, the European Society of Cardiology and the European Society of Anaesthesiology have joined and published the guidelines for the perioperative cardiovascular management of patients scheduled to undergo non-cardiac surgery. The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) represents the most complete and accurate prediction tool so far. It includes 21 preoperative factors relating to demographics, comorbidities and procedures able to predict outcomes based on preoperative risk factors such as death, cardiac complications, pneumonia, and acute kidney injury. The present article will address aspects related to common aspects concerning modifiable and non-modifiable that should be addressed in every patient to whom elective surgery has been scheduled.  

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Published
2017-07-18
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Cardiology - Original Articles
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How to Cite
Romagnoli, Stefano, Laura Paparella, and Paolo Boninsegni. 2017. “The Criteria of “inoperability””. Monaldi Archives for Chest Disease 87 (2). https://doi.org/10.4081/monaldi.2017.851.

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