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- Alexander Kulikov, Shaun E Gruenbaum, Alfredo Quinones-Hinojosa, Pier Paolo Pugnaloni, Andrey Lubnin, and Federico Bilotta.
- Department of Anesthesiology, Burdenko National Medical Research Center of Neurosurgery, Moscow, Russia.
- World Neurosurg. 2024 Jun 1; 186: 687768-77.
ObjectivePerioperative risk assessment and stratification before craniotomy is necessary to identify and optimize modifiable risk factors. Due to the high costs of diagnostic testing and concerns for delaying surgery, some have questioned whether and when surgery delays are warranted and supported by the current body of literature. The objective of this scoping review was to evaluate the available evidence on the prognostic value of preoperative risk assessment before anesthesia for elective craniotomy.MethodsIn this scoping review, we reviewed 156 papers that assess preoperative risk assessment before elective craniotomy, of which 27 papers were included in the final analysis.ResultsThere is little high-quality evidence to suggest significant risk reduction when 4 common preexisting abnormalities are present: preoperative chronic aspirin therapy, cardiac arrhythmias, deep vein thrombosis, or hyperglycemia.ConclusionsThe risk of delaying craniotomy should ultimately be weighed against the perceived risks associated the patient's comorbid conditions and should be considered on an individualized basis.Copyright © 2024 Elsevier Inc. All rights reserved.
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