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Surgical Risk Factors

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Thyroid Dysfunction

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Both hypothyroidism and hyperthyroidism can lead to significant metabolic complications, impact cardiovascular stability, and influence the response to anesthetic drugs.

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Renal Insufficiency

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Impaired kidney function can lead to difficulties in fluid and electrolyte balance, increased risk of postoperative kidney injury, and problems with medication elimination.

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Obstructive Sleep Apnea (OSA)

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OSA increases the risk of postoperative respiratory complications, including hypoxemia and airway obstruction, and may affect pain management due to opiate sensitivity.

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Age

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Older patients often have a higher risk of surgical complications due to a general decline in physiological reserves and potential presence of comorbid conditions.

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Previous Surgical History

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Previous operations, especially in the same area, can increase the risk of adhesions and technical difficulties during repeat surgeries.

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Hypertension

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Uncontrolled high blood pressure can increase the risk of bleeding, cardiac events, and stroke during surgery, and can impact the choice and management of anesthesia.

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Coagulation Disorders

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Abnormal blood clotting can lead to increased risk of bleeding or thrombosis, affecting surgical technique and necessitating careful postoperative monitoring.

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Preoperative Anemia

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Anemia can lead to decreased oxygen carrying capacity, resulting in increased risk of perioperative morbidity, and necessitates careful consideration regarding blood transfusions.

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Electrolyte Imbalance

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Abnormal electrolyte levels can cause complications such as cardiac arrhythmias and neurological disturbances, affecting perioperative management and recovery.

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Performance Status

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A patient's physical fitness and ability to carry out daily activities affects their risk for surgery and can predict the likelihood of postoperative complications and recovery.

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Medication Use

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Certain medications, like antiplatelets or anticoagulants, increase the risk of perioperative bleeding, while others can interact with anesthetic agents.

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Smoking

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Smoking can impair wound healing, increase the risk of respiratory complications, and negatively impact cardiovascular health, leading to a higher risk of complications during and after surgery.

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Obesity

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Obesity increases surgical risk through associated comorbidities like cardiovascular disease, diabetes, and an increased likelihood of postoperative complications (e.g., infections, wound healing problems).

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Liver Disease

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Liver dysfunction can alter the metabolism of drugs, affect coagulation, and lead to an increased risk of bleeding and postoperative liver decompensation.

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Alcohol Abuse

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Chronic alcohol consumption can lead to liver dysfunction, increased bleeding risks, and can cause withdrawal symptoms postoperatively, complicating recovery.

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Goldman Cardiac Risk Index

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This is a scoring system used to estimate the risk of cardiac complications after surgery based on factors like age, history of MI, and type of surgery.

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Chronic Steroid Use

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Long-term steroid use can impact immune function, wound healing, and blood sugar control, possibly increasing the risk of infection and other complications.

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Cardiovascular Disease

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Patients with cardiovascular disease are at a higher risk for cardiac events during and after surgery, and may experience difficulties with anesthesia and fluid management.

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Pulmonary Disease

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Pre-existing lung conditions such as COPD can increase the risk of respiratory failure, pneumonia, and prolonged mechanical ventilation post surgery.

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Immunosuppression

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Immunocompromised patients have an increased risk of infections and may have a delayed healing process due to a weakened immune system.

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Anesthetic History

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A history of adverse reactions to anesthesia can increase the risk of complications and influences the choice of anesthetic technique and agents for future surgeries.

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Nutritional Deficiencies

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Deficiencies in essential nutrients can impair tissue repair, immune response, and contribute to a higher susceptibility to infection.

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Autoimmune Diseases

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Autoimmune conditions may necessitate special perioperative management, increase the risk of infection, and affect wound healing due to immune dysregulation.

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Psychological Factors

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Stress, anxiety, and depression can affect recovery, compliance with postoperative care, and the overall surgery experience.

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BMI Extreme (Underweight or Morbidly Obese)

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Both extremes of BMI can increase surgical risk due to potential nutritional status issues, dosing challenges with medication and anesthesia, and increased difficulty in surgical technique.

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Family History of Surgical Complications

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A known family history of complications such as malignant hyperthermia can increase the risk of similar reactions and should guide anesthetic choices.

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Infectious Status (MRSA, VRE, etc.)

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Patients carrying or infected with multi-drug resistant organisms (MDROs) like MRSA or VRE have a higher risk of postoperative infections and may require isolation and additional precautions.

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History of Deep Vein Thrombosis or Pulmonary Embolism

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Patients with a history of DVT or PE are at increased risk for recurrence and may require specific prophylactic measures to prevent thrombotic events around the time of surgery.

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Malnutrition

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Poor nutritional status can weaken immune response, impair wound healing, and increase the risk of infection, all of which can negatively influence surgical outcomes.

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Diabetes Mellitus

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Diabetes increases the risk of infection, may lead to poorer wound healing, and can complicate the management of blood glucose levels around the time of surgery.

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