Preoperative Optimization for Orthopaedic Surgery: Steps to Reduce Complications.
Lauren M ShapiroMichael P BolognesiKevin BozicRobin Neil KamalPublished in: The Journal of the American Academy of Orthopaedic Surgeons (2023)
As the population ages and patients maintain higher levels of activity, the incidence of major and minor orthopaedic procedures continues to rise. At the same time, health policies are incentivizing efforts to improve the quality and value of musculoskeletal health services. As such, orthopaedic surgeons play a key role in directing the optimization of patients before surgery by assessing patient risk factors to inform risk/benefit discussions during shared decision-making and designing optimization programs to address modifiable risks. These efforts can lead to improved health outcomes, reduced costs, and preference-congruent treatment decisions. In this review, we (1) summarize the evidence on factors known to affect outcomes after common orthopaedic procedures, (2) identify which factors are considered modifiable and amenable to preoperative intervention, and (3) provide guidance for preoperative optimization.
Keyphrases
- risk factors
- end stage renal disease
- public health
- minimally invasive
- ejection fraction
- newly diagnosed
- chronic kidney disease
- patients undergoing
- quality improvement
- healthcare
- randomized controlled trial
- prognostic factors
- peritoneal dialysis
- coronary artery bypass
- climate change
- percutaneous coronary intervention
- health information
- replacement therapy
- social media
- health promotion