Zöllner Christian
Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Anästhesiologie, Zentrum für Anästhesiologie und Intensivmedizin, Martinistr. 52, 20246, Hamburg, Deutschland.
Anaesthesiologie. 2024 May;73(5):294-323. doi: 10.1007/s00101-024-01408-2. Epub 2024 May 3.
The 70 recommendations summarize the current status of preoperative risk evaluation of adult patients prior to elective non-cardiothoracic surgery. Based on the joint publications of the German scientific societies for anesthesiology and intensive care medicine (DGAI), surgery (DGCH), and internal medicine (DGIM), which were first published in 2010 and updated in 2017, as well as the European guideline on preoperative cardiac risk evaluation published in 2022, a comprehensive re-evaluation of the recommendation takes place, taking into account new findings, the current literature, and current guidelines of international professional societies. The revised multidisciplinary recommendation is intended to facilitate a structured and common approach to the preoperative evaluation of patients. The aim is to ensure individualized preparation for the patient prior to surgery and thus to increase patient safety. Taking into account intervention- and patient-specific factors, which are indispensable in the preoperative risk evaluation, the perioperative risk for the patient should be minimized and safety increased. The recommendations for action are summarized under "General Principles (A)," "Advanced Diagnostics (B)," and the "Preoperative Management of Continuous Medication (C)." For the first time, a rating of the individual measures with regard to their clinical relevance has been given in the present recommendation. A joint and transparent agreement is intended to ensure a high level of patient orientation while avoiding unnecessary preliminary examinations, to shorten preoperative examination procedures, and ultimately to save costs. The joint recommendation of DGAI, DGCH and DGIM reflects the current state of knowledge as well as the opinion of experts. The recommendation does not replace the individualized decision between patient and physician about the best preoperative strategy and treatment.
这70条建议总结了成年患者在择期非心胸外科手术前的术前风险评估现状。基于德国麻醉学与重症医学科学协会（DGAI）、外科学会（DGCH）和内科学会（DGIM）于2010年首次发表并于2017年更新的联合出版物，以及2022年发布的欧洲术前心脏风险评估指南，综合考虑新发现、当前文献以及国际专业学会的现行指南，对这些建议进行了全面重新评估。修订后的多学科建议旨在促进对患者进行术前评估时采用结构化的通用方法。目的是确保患者在手术前得到个性化准备，从而提高患者安全性。考虑到术前风险评估中不可或缺的干预因素和患者特定因素，应将患者的围手术期风险降至最低并提高安全性。行动建议归纳在“一般原则（A）”、“高级诊断（B）”和“持续用药的术前管理（C）”之下。本建议首次对各项措施的临床相关性进行了评级。旨在达成一项联合且透明的共识，以确保高度以患者为导向，同时避免不必要的初步检查，缩短术前检查程序，并最终节省成本。DGAI、DGCH和DGIM的联合建议反映了当前的知识水平以及专家意见。该建议并不取代患者与医生之间就最佳术前策略和治疗方案做出的个性化决策。
