TY - CHAP M1 - Book, Section TI - Preoperative Evaluation of the Thoracic Surgical Patient A1 - Nagasawa, Kelly K. A1 - Doty, John R. A2 - Yuh, David D. A2 - Vricella, Luca A. A2 - Yang, Stephen C. A2 - Doty, John R. Y1 - 2014 N1 - T2 - Johns Hopkins Textbook of Cardiothoracic Surgery AB - Role of preoperative evaluationThe role of the preoperative evaluation is to (1) determine the risk and morbidity associated with the proposed operation and (2) identify any patient conditions or factors that can be treated to mitigate the risk of morbidity and mortality.History and physical examinationThe examination should focus on pulmonary and cardiac conditions, as these represent the most common complications after thoracic surgery.Functional and performance statusThe patient’s ability to withstand and recover from a major thoracic operation should be assessed prior to surgery. Standard tests such as the Karnofsky score, Zubrod score, DASI questionnaire, stair climbing, and shuttle walk are all useful metrics.Pulmonary and cardiac testingPulmonary function testing remains the cornerstone of preoperative evaluation. FEV1, DLCO, and postoperative predicted values are important predictors of outcomes. Assessment of cardiovascular risk should include noninvasive testing in patients with a history of cardiac disease and more invasive testing as indicated.Risk stratification modelsMathematical models using the Epithor and Society of Thoracic Surgeons General Thoracic Database can provide reasonably accurate risk stratification for patients undergoing major thoracic surgery. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesssurgery.mhmedical.com/content.aspx?aid=1104583773 ER -