Perioperative Medicine in the United States

SummaryImproving management of chronic medical conditions has contributed to increased life expectancy and a rising prevalence of severe comorbidities among surgical patients. Not surprisingly, the concept of perioperative medicine remains topical, in part due to this increase in patient acuity, coupled with imperatives to improve outcomes while controlling costs. Perioperative medicine is a relevant concept with increasingly overlapping boundaries between the traditional specialties. However, there has not been a uniform approach towards delineating the exact boundaries of, and the actual implementation of the relevant components of perioperative medicine. In this paper, we present an overview of our institution's approach developed according to the needs of a main tertiary referral center for a sparsely populated but geographically widespread largely rural state.

ZusammenfassungDie zunehmende Häufigkeit von chirurgischen Patienten mit relevanten Systemerkrankungen, das steigende Durchschnittsalter der Bevölkerung und die berechtigten Ansprüche der Patienten auf eine optimale Behandlung nach einem operativen Eingriff bedingen eine zunehmende Komplexität der perioperativen Behandlung. Wir beschreiben den interdisziplinären Ansatz in unserer Klinik, der gemäß den Anforderungen an ein “main tertiary referral center” in einem dünn besiedelten Flächenstaat (Iowa) entwickelt wurde.