Preoperative Assessment Proposal ; Propuesta de Valoración Preoperatoria

OBJECTIVES: To design two different surgical patient groups with nonsimilar surgical risks one of them in normal range an the other in high risk. MATERIALS AND METHODS: Two groups of patients of a hundred cases each were evaluated. The first group of healthy kidney donors underwent unilateral nephrectomy, were thoroughly studied in accordance to a preestablished protocol. This protocol was analyzed and we established twelve types of surgical risks, having a risk scale that ranges from I to IV. In the second group of patients who underwent high risk major abdominal surgery we established a scoring method that allows us to determine the patient prognosis. RESULTS: The study demostrated differences in the preoperative assessments.In the fisrt group 99,75% of patients presented risk I, in the other group more than 40 % presented risk II to IV. The morbimortality had a significative difference: 1 % in donors and 19% in the ones of major surgery. Only in the second group there was 4% of mortality. CONCLUSIONS: Group I patients had excellent course, high risk patients had high morbi-mortality, the here proposed preoperative assessment must be used in high risk patients since it allows us to establish the patient prognosis. ; OBJETIVOS: Diseñar dos grupos diferentes operados con riesgos quirúrgicos disímiles, uno en el límite norinal y otro de alto riesgo. MATERIALES Y MÉTODOS: Se evaluó dos grupos de pacientes de cien casos cada uno. El primer grupo de donantes renales sanos sometidos a Nefrectomía unilateral, fue estudiado en forma completa de acuerdo a un protocolo establecido. Analizamos este protocolo y establecimos doce tipos de riesgos quirúrgicos, con una escala de riesgos de I a IV. En el segundo grupo de pacientes,de Cirugía mayor abdominal de alto riesgo, establecimos un método de puntuación que nos permite establecer un pronóstico del paciente. RESULTADOS: El estudio demostró diferencias de las evaluaciones preoperatorias. El primer grupo el 99,75% presentó riesgo I, mientras que en el otro grupo más del 40% ...