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Preoperative evaluation of the adult patient undergoing non-cardiac surgery: guidelines from the European Society of Anaesthesiology

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Abstract
The purpose of these guidelines on the preoperative evaluation of the adult non-cardiac surgery patient is to present recommendations based on available relevant clinical evidence. The ultimate aims of preoperative evaluation are two-fold. First, we aim to identify those patients for whom the perioperative period may constitute an increased risk of morbidity and mortality, aside from the risks associated with the underlying disease. Second, this should help us to design perioperative strategies that aim to reduce additional perioperative risks. Very few well performed randomised studies on the topic are available and many recommendations rely heavily on expert opinion and are adapted specifically to the healthcare systems in individual countries. This report aims to provide an overview of current knowledge on the subject with an assessment of the quality of the evidence in order to allow anaesthetists all over Europe to integrate - wherever possible - this knowledge into daily patient care. The Guidelines Committee of the European Society of Anaesthesiology (ESA) formed a task force with members of subcommittees of scientific subcommittees and individual members of the ESA. Electronic databases were searched from the year 2000 until July 2010 without language restrictions. These searches produced 15 425 abstracts. Relevant systematic reviews with meta-analyses, randomised controlled trials, cohort studies, case-control studies and cross-sectional surveys were selected. The Scottish Intercollegiate Guidelines Network grading system was used to assess the level of evidence and to grade recommendations. The final draft guideline was posted on the ESA website for 4 weeks and the link was sent to all ESA members, individual or national (thus including most European national anaesthesia societies). Comments were collated and the guidelines amended as appropriate. When the final draft was complete, the Guidelines Committee and ESA Board ratified the guidelines.
Keywords
OBSTRUCTIVE SLEEP-APNEA, ACUTE KIDNEY INJURY, DIFFICULT TRACHEAL INTUBATION, RANDOMIZED CONTROLLED-TRIAL, LIP BITE TEST, CHRONIC RENAL-INSUFFICIENCY, GELATINASE-ASSOCIATED LIPOCALIN, PERIPHERAL ARTERIAL-DISEASE, MULTIVARIATE RISK INDEX, MORBIDLY OBESE-PATIENTS

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Citation

Please use this url to cite or link to this publication:

Chicago
De Hert, Stefan, Georgina Imberger, John Carlisle, Pierre Diemunsch, Gerhard Fritsch, Iain Moppett, Maurizio Solca, et al. 2011. “Preoperative Evaluation of the Adult Patient Undergoing Non-cardiac Surgery: Guidelines from the European Society of Anaesthesiology.” European Journal of Anaesthesiology 28 (10): 684–722.
APA
De Hert, Stefan, Imberger, G., Carlisle, J., Diemunsch, P., Fritsch, G., Moppett, I., Solca, M., et al. (2011). Preoperative evaluation of the adult patient undergoing non-cardiac surgery: guidelines from the European Society of Anaesthesiology. EUROPEAN JOURNAL OF ANAESTHESIOLOGY, 28(10), 684–722.
Vancouver
1.
De Hert S, Imberger G, Carlisle J, Diemunsch P, Fritsch G, Moppett I, et al. Preoperative evaluation of the adult patient undergoing non-cardiac surgery: guidelines from the European Society of Anaesthesiology. EUROPEAN JOURNAL OF ANAESTHESIOLOGY. 2011;28(10):684–722.
MLA
De Hert, Stefan, Georgina Imberger, John Carlisle, et al. “Preoperative Evaluation of the Adult Patient Undergoing Non-cardiac Surgery: Guidelines from the European Society of Anaesthesiology.” EUROPEAN JOURNAL OF ANAESTHESIOLOGY 28.10 (2011): 684–722. Print.
@article{1904407,
  abstract     = {The purpose of these guidelines on the preoperative evaluation of the adult non-cardiac surgery patient is to present recommendations based on available relevant clinical evidence. The ultimate aims of preoperative evaluation are two-fold. First, we aim to identify those patients for whom the perioperative period may constitute an increased risk of morbidity and mortality, aside from the risks associated with the underlying disease. Second, this should help us to design perioperative strategies that aim to reduce additional perioperative risks. Very few well performed randomised studies on the topic are available and many recommendations rely heavily on expert opinion and are adapted specifically to the healthcare systems in individual countries. This report aims to provide an overview of current knowledge on the subject with an assessment of the quality of the evidence in order to allow anaesthetists all over Europe to integrate - wherever possible - this knowledge into daily patient care. The Guidelines Committee of the European Society of Anaesthesiology (ESA) formed a task force with members of subcommittees of scientific subcommittees and individual members of the ESA. Electronic databases were searched from the year 2000 until July 2010 without language restrictions. These searches produced 15 425 abstracts. Relevant systematic reviews with meta-analyses, randomised controlled trials, cohort studies, case-control studies and cross-sectional surveys were selected. The Scottish Intercollegiate Guidelines Network grading system was used to assess the level of evidence and to grade recommendations. The final draft guideline was posted on the ESA website for 4 weeks and the link was sent to all ESA members, individual or national (thus including most European national anaesthesia societies). Comments were collated and the guidelines amended as appropriate. When the final draft was complete, the Guidelines Committee and ESA Board ratified the guidelines.},
  author       = {De Hert, Stefan and Imberger, Georgina and Carlisle, John and Diemunsch, Pierre and Fritsch, Gerhard and Moppett, Iain and Solca, Maurizio and Staender, Sven  and Wappler, Frank and Smith, Andrew and Task Force on Preoperative Evaluation of the Adult Noncardiac Surgery Patient of the European Society of Anaesthesiology,  },
  issn         = {0265-0215},
  journal      = {EUROPEAN JOURNAL OF ANAESTHESIOLOGY},
  keyword      = {OBSTRUCTIVE SLEEP-APNEA,ACUTE KIDNEY INJURY,DIFFICULT TRACHEAL INTUBATION,RANDOMIZED CONTROLLED-TRIAL,LIP BITE TEST,CHRONIC RENAL-INSUFFICIENCY,GELATINASE-ASSOCIATED LIPOCALIN,PERIPHERAL ARTERIAL-DISEASE,MULTIVARIATE RISK INDEX,MORBIDLY OBESE-PATIENTS},
  language     = {eng},
  number       = {10},
  pages        = {684--722},
  title        = {Preoperative evaluation of the adult patient undergoing non-cardiac surgery: guidelines from the European Society of Anaesthesiology},
  url          = {http://dx.doi.org/10.1097/EJA.0b013e3283499e3b},
  volume       = {28},
  year         = {2011},
}

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