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The concept of peri-operative medicine to prevent major adverse events and improve outcome in surgical patients

A narrative review

Bollen Pinto, Bernardo; Chew, Michelle; Lurati Buse, Giovanna; Walder, Bernhard

European Journal of Anaesthesiology: December 2019 - Volume 36 - Issue 12 - p 889–903
doi: 10.1097/EJA.0000000000001067
Review article
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Peri-operative Medicine is the patient-centred and value-based multidisciplinary peri-operative care of surgical patients. Peri-operative stress, that is the collective response to stimuli occurring before, during and after surgery, is, together with pre-existing comorbidities, the pathophysiological basis of major adverse events. The ultimate goal of Peri-operative Medicine is to promote high quality recovery after surgery. Clinical scores and/or biomarkers should be used to identify patients at high risk of developing major adverse events throughout the peri-operative period. Allocation of high-risk patients to specific care pathways with peri-operative organ protection, close surveillance and specific early interventions is likely to improve patient-relevant outcomes, such as disability, health-related quality of life and mortality.

From the Division of Anaesthesiology, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals (BBP, BW), Geneva Perioperative Basic, Translational and Clinical Research Group, Geneva, Switzerland (BBP, BW), Department of Anaesthesia and Intensive Care, Medical and Health Sciences, Linköping University, Linköping, Sweden (MC) and Department of Anaesthesiology, University Hospital Düsseldorf, Düsseldorf, Germany (GLB)

Correspondence to Bernardo Bollen Pinto, MD, PhD, Division of Anaesthesiology, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine, Geneva University Hospitals, Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland Tel: +41 789401810; fax: +41 223727511; e-mail: bernardo.bollenpinto@hcuge.ch

Published online 23 August 2019

© 2019 European Society of Anaesthesiology