Current UK practice of pre-operative risk assessment prior to neurosurgery

British Journal of Neurosurgery
Smita Bapat, Astri M V Luoma

Abstract

Intra-cranial and spinal surgery is associated with significant morbidity (23.6% and 11.2%) (5) . Fully informed consent, shared decision-making and optimal peri-operative care are essential to ensure excellent surgical outcome. There is evidence to support the use of formal pre-operative risk assessment to facilitate this in non-cardiac surgery but little is published on best practice for neurosurgery. Our aim was to establish current practice in pre-operative risk assessment at UK Neurosciences centres. A national peer-reviewed electronic structured survey on current practice of pre-operative risk assessment was conducted through the Neuroanaesthesia Society of Great Britain and Ireland or NASGBI in 2014. We received a response from every UK neurosciences centre. 85% of neurosurgical units offer pre-operative assessment or PAC for elective admissions with 32% of respondents performing formal risk assessment. The Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) and its Portsmouth (P-POSSUM) modification were used most frequently. Although formal multi-disciplinary team discussions were conducted rarely following risk assessment, the results guided post-operative care and were u...Continue Reading

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