CHECKLIST OF ANESTHETIC RISK-FACTORS AND CRITERIA

When considering the risks of anaesthetic and surgery, the anaesthetic risk in the narrower sense should be differentiated from the overall operative risk. This latter is determined both by the existing diseases and by the nature of the anaesthesiological and surgical intervention, together with their interaction. An analysis of the overall operative risk is based on efforts to obtain an objective estimation of expected complications and the danger to the patient. Such classification systems as the "Munich Risk Checklist" take into account the influence of individual risk factors of proven significance, and evaluate them on the basis of a points scoring system. Major risk factors have been identified to be previous cardiac or pulmonary diseases of the patient, his/her age, and general state of health. In this connection, coronary heart disease is of special importance. The area of surgical intervention and the selection of the best time for operation are also risk determinants. Anaesthetic risk checklists, the prognostic reliability of which has been documented, are a highly suitable means of determining preoperative risk, and are thus a useful aid for the selection of an anaesthetic procedure tailored to the surgical intervention involved and for making decisions about the nature and extent of monitoring or the nature of postoperative care.