Respiratory risk assessment prior to extrathoracic surgery

Physicians are often asked to evaluate a patient prior to elective surgery for the purpose of risk identification and modification. Postoperative pulmonary complications are the most costly of the major postoperative medical complications, including cardiac, thromboembolic and infectious, and result in the lengthiest hospital stays. Therefore, estimation of respiratory risk should be a routine element of all preoperative medical evaluations. A diligent preoperative clinical evaluation, supplemented with appropriate preoperative pulmonary function testing, would identify the majority of important risk factors for postoperative complications. Risk reduction strategies can then be implemented to reduce complications, cost, and hospital stay.