Anesthesiologists and surgeons employ various methods in assessing whether a patient is in optimal condition from a medical standpoint prior to undertaking surgery, and various statistical tools are available.
[12] A 2009 Cochrane systematic review aimed to assess the effects of strict blood glucose control around the time of operation to prevent SSIs.
The authors concluded that there was insufficient evidence to support the routine adoption of this practice and that more randomized controlled trials were needed to address this research question.
[13] Examples are deep vein thrombosis and pulmonary embolism, the risk of which can be mitigated by certain interventions, such as the administration of anticoagulants (e.g., warfarin or low molecular weight heparins), antiplatelet drugs (e.g., aspirin), compression stockings, and cyclical pneumatic calf compression in high risk patients.
(A major PPC can be defined as a postoperative pneumonia, respiratory failure, or the need for reintubation after extubation at the end of an anesthetic.
Minor post-operative pulmonary complications include events such as atelectasis, bronchospasm, laryngospasm, and unanticipated need for supplemental oxygen therapy after the initial postoperative period.)
[15] Respiratory therapy has a place in preventing pneumonia related to atelectasis, which occurs especially in patients recovering from thoracic and abdominal surgery.
[citation needed] Most perioperative mortality is attributable to complications from the operation (such as bleeding, sepsis, and failure of vital organs) or pre-existing medical conditions.
A study based on extrapolation from existing data sources estimated that 4.2 million people die within 30 days of surgery every year, with half of these deaths occurring in low- and middle-income countries.
Mortality directly related to anesthetic management is less common, and may include such causes as pulmonary aspiration of gastric contents,[19] asphyxiation[20] and anaphylaxis.
[22] In a 1954 review of 599,548 surgical procedures at 10 hospitals in the United States between 1948 – 1952, 384 deaths were attributed to anesthesia, for an overall mortality rate of 0.064%.
In this review of 3.7 million surgical procedures at 102 hospitals in the Netherlands during 1991 – 2005, postoperative mortality from all causes was observed in 67,879 patients, for an overall rate of 1.85%.