Abstract
Modern surgical, anaesthetic, and nursing care has increased the safety of gynecological surgery. Clinicians as well as patients may consider it to be routine, with very low risk. However, for a small cohort of patients the physiological insult of surgery exposes them to significant risks of morbidity and mortality; these patients are usually elderly, often with malignancy or cardio-pulmonary comorbidities, and having major or emergency surgery. The leading causes of intensive treatment unit (ITU) admission in postoperative gynecology patients are hemorrhage, infection, and cardiorespiratory failure, and in these patients the 6-month mortality is 26% [1]. For those age >69 years having major open procedures, the 60-day mortality rate is up to 5% [2]. The challenge remains to accurately identify those patients who have the highest risk, to stratify their level of risk, and to modify management to ameliorate the hazards. Doing so facilitates the benefits of surgery for a group of patients for whom it may previously have been denied. In any healthcare system with limited resources, it is imperative that such resources are targeted appropriately toward those with the highest risk.
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Glover, G.W., Cramp, P.G. (2008). The High-Risk Gynecology Patient: Assessment and Management. In: O’Donovan, P. (eds) Complications in Gynecological Surgery. Springer, London. https://doi.org/10.1007/978-1-84628-883-8_10
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DOI: https://doi.org/10.1007/978-1-84628-883-8_10
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