Preoperative assessment in low complexity outpatient dermatologic surgery
DOI:
https://doi.org/10.11606/issn.1679-9836.v102i4e-204196Keywords:
Perioperative care, Cardiovascular risk, Heart complicationsAbstract
Introduction: The preoperative evaluation provides data about the patient, which will help in the preparation of the surgery. In outpatient, low-complexity surgeries, the criteria for carrying out this evaluation are not well defined in the guidelines. Objective: to compare assessment strategies and their impact on perioperative evolution. Method: Prospective and controlled study in dermatologic surgery. Low and moderate risk patients were included according to the EMAPO score (Multicenter Perioperative Evaluation Study for Non-Cardiac Surgery). Divided into two groups: (G1) evaluation with the surgeon; (G2) evaluation with surgeon and cardiologist. Seven-day follow-up. Data on the procedure, evolution and adverse events were analyzed. Statistical evaluation: Shapiro-Wilk. Pearson's χ2 test and T or Mann-Whitney test (95% CI with P<0.05). Results: 299 patients evaluated (G1=200 and G2=99). All cleared for surgery, without any special guidance. Homogeneous groups, EMAPO (G1=2.6 ± 3.6 and G2=2.7 ± 3.2), except for dyslipidemia (G1=13.5% and G2=23.2% p=0.03). There were no cardiovascular events. Three patients in G2 and one in G1 had surgical wound infection. G2 patients underwent more tests (5.1 ± 1.7 vs 1.3 ± 1.7; p<0.01). The waiting time for the surgery was shorter in G1 (2.7 ± 2.1 months) compared to G2 (6.8 ± 4.6m) (p<0.01). Conclusion: There is no need for preoperative evaluation with a cardiologist and/or more tests in low or medium risk patients according to the EMAPO score for outpatient dermatological surgeries.
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