Oncogeriatrics (part 6.). The usefulness of routine preoperative investigations in the qualification of an older patient for elective surgery

Medical history, physical examination and a Comprehensive Geriatric Assessment remain the most important elements in preparing an older patient for surgery, to determine the number of preoperative additional tests, and remain the strongest predictors of postoperative outcome. The additional 40-60 minutes devoted to its implementation at the time of qualifi­cation for surgery, is well worth the chance to significantly reduce the risk of complications in the postoperative period. The patient’s chronological age alone is not a criterion for the type and number of additional tests. Routine biochemical blood serum tests (with the exceptions of haemoglobin, creatinine, albumin and HbA1c in diabetic patients) and other preoperative static investigations have not been shown to affect the risk of postoperative complications, no more so in the older population. It is also misleading to believe that a large number of preoperative tests will protect the attending physician from legal liability.