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Criteria and medical conditions for which preoperative evaluation is recommended before the date of surgery

Criteria and medical conditions for which preoperative evaluation is recommended before the date of surgery
Medical condition
General
Normal activity inhibited
Monitoring or medical assistance at home within two months
Hospital admission within two months
Obesity (BMI >40 kg/m2)
Frailty
Malnourishment
Cardiovascular
Coronary artery disease
Arrhythmias
Systolic blood pressure >160 mmHg or diastolic blood pressure >100 mmHg
Heart failure
Respiratory
Asthma, severe
COPD with symptoms
Exacerbation or progression of COPD or asthma within two months
Previous airway surgery
Unusual airway anatomy
Airway tumor or obstruction
Home ventilatory assistance or monitoring
OSA without PAP therapy
Endocrine
Diabetes requiring insulin therapy
Adrenal disorders
Active thyroid disease
Central nervous system/Neuromuscular
Seizure disorder
CNS disease (eg, multiple sclerosis)
Myopathy or other muscle disorders
Hepatic
Active hepatobiliary disease or compromise
Renal
Renal insufficiency or failure
Musculoskeletal
Kyphosis or scoliosis compromising function
Temporomandibular joint disorder limiting mouth opening
Cervical or thoracic spine injury/disease
Oncology
Chemo- or radiotherapy within last two months
Significant physiologic compromise from disease or treatment
Criteria
Age
>65 years, unless surgery is minor (eg, cataract, cystoscopy) and under monitored anesthesia care
Language
Patient or parent/guardian cannot hear, speak, or understand English
Anesthesia related
Patient has had previous difficult intubation, paralysis or nerve damage during anesthesia, or patient or family has had previous elevated temperature during anesthesia, is allergic to succinylcholine, has malignant hyperthermia or pseudocholinesterase deficiency 
Procedure related
Intraoperative blood transfusion likely
ICU admission likely
High-risk surgery
Pregnancy
Patient is pregnant (unless the procedure is termination)
This table shows medical conditions and other patient criteria for preanesthesia evaluation before the day of surgery. For further information, refer to UpToDate content on preanesthesia evaluation for noncardiac surgery.
BMI: body mass index; COPD: chronic obstructive pulmonary disease; OSA: obstructive sleep apnea; PAP: positive airway pressure; CNS: central nervous system; ICU: intensive care unit.
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