Table 2 Perioperative Risk Optimization and Management Planning Tool (PROMPT™) qualitative survey results
A. Preoperative Testing | |
1. Laboratory (11) | |
2. Cardiovascular (10) | |
3. Pulmonary function (2) | |
B. Medications and Technologies | |
1. Beta-blockers | |
2. Calcium channel blockers | |
3. Diuretics | |
4. Angiotensin-converting enzyme inhibitors | |
5. Angiotensin receptor blockers | |
6. Anticoagulants (17) | |
7. Coronary artery stents (6) | |
8. Cardiac pacemakers (4) | |
9. Implantable cardioverter defibrillators | |
10. Insulin pumps | |
11. Intrathecal pumps | |
12. Other implantable devices (vagal nerve stimulators, deep brain stimulators) | |
C. Optimization of Co-Morbid Diseases | |
1. Arterial hypertension (25) | |
2. Coronary artery disease (3) | |
3. Cardiomyopathy | |
4. Congestive heart failure (3) | |
5. Cardiac arrhythmias (5) | |
6. Diabetes mellitus (18) | |
7. Cerebrovascular disease (2) | |
8. Chronic obstructive pulmonary disease (2) | |
9. Obstructive sleep apnea (10) | |
10. Pulmonary hypertension | |
11. Renal insufficiency (6) | |
12. Cirrhosis and liver failure | |
13. Anemia (8) | |
14. Obesity (7) | |
15. Infection and sepsis (11) | |
16. Trauma (3) | |
17. Chronic pain/chronic opioid use (15) | |
18. Substance abuse (3) | |
19. Malignant hyperthermia | |
20. Reported penicillin allergy | |
D. Perioperative Risk Reduction | |
1. Cognitive delirium (7) | |
2. Cognitive dysfunction (4) | |
3. Nausea and vomiting (21) | |
4. Deep venous thrombosis (8) | |
5. Cerebrovascular accident | |
6. Myocardial injury after non-cardiac surgery (“MINS”) | |
7. Acute kidney injury and renal failure (2) | |
E. Provision of Comprehensive Care | |
1. Choice of anesthetic technique and agents (11) | |
2. Airway management (4) | |
3. Ventilation (12) | |
4. Glucose management (not just in diabetics) (9) | |
5. Nutrition (2) | |
6. Fluid and Electrolyte Management (16) | |
7. Patient-centered blood management (11) | |
8. Patient medication instruction and compliance (5) | |
9. Preoperative physical conditioning (“prehabilitation”) (2) | |
10. Smoking cessation (3) | |
11. Perioperative opioid sparring strategies (“multimodal analgesia”) (13) | |
12. Perioperative sedative sparring strategies | |
13. Preoperative antimicrobial prophylaxis and skin preparation | |
14. Intraoperative hypothermia prevention (maintaining normothermia) | |
15. Geriatric anesthetic and analgesic management (3) |