Perioperative Care: A Review of Guidelines and Recommendations—Part 1 Preoperative Evaluation

Recommendations regarding preoperative assessment, particularly with respect to laboratory testing and imaging, have changed dramatically in recent years. Historically, extensive preoperative testing was performed, even in young, healthy patients undergoing minor procedures. Recent evidence has demonstrated liberal preoperative testing strategies to be cost ineffective, and national guidelines have shifted toward more restrictive testing based on formal risk assessment. Even as guidelines have shifted, however, inappropriate use of preoperative testing continues, at an enormous cost to the health care system.2,3 As increasing attention is paid to the cost of care delivery, familiarity with risk assessment tools and testing recommendations is important to delivery of effective, cost-efficient surgical care.