Key result
Preoperative comprehensive health assessment mitigates perioperative risks in children with medical complexity.
Why the study?
Children with medical complexity undergoing major surgery have the highest risk of postoperative complications, physiologic decline, and protracted recovery among pediatric populations.
A preoperative comprehensive health assessment is recommended to detect and mitigate perioperative risk factors in children with medical complexity.
Supports targeted pre-operative assessments in pediatric patients; extends observational data but remains hypothesis-generating pending RCTs.
Although surgery can be effective to optimize the health and function of children with medical complexity (CMC), these children exhibit the highest risk of postoperative complications, physiologic decline, and protracted recovery of all pediatric populations. The preoperative comprehensive health assessment (PreopCHA) is a comprehensive "head-to-toe" review and synthesis of a child's health, function, family/social attributes, and array of current treatments. The PreopCHA enables the detection and mitigation of perioperative risk factors of surgery months in advance, when possible. PreopCHA is paramount for all CMC undergoing surgery. This article covers the importance, components, and implementation suggestions for PreopCHA in CMC.
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Mariani et al. (2026) conducted a review in Children with medical complexity undergoing major surgery. Preoperative comprehensive health assessment (PreopCHA) was evaluated. Preoperative comprehensive health assessments (PreopCHA) are recommended for children with medical complexity undergoing surgery to detect and mitigate perioperative risk factors.
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