Perioperative management of the hospitalized patient.

The hospitalized surgical patient requires a team approach. Because of increasing patient age and complexity of conditions, a comprehensive preoperative evaluation and medical optimization is often necessary to allow the anesthesiologist and surgeon to deliver the best surgical outcome. Surgical patients at an increased risk for postoperative complications should be followed carefully by a medical consultant throughout the hospital stay. This continuity of perioperative care improves the likelihood that postoperative problems, such as delirium, early myocardial ischemia, or VTE, are quickly identified, and appropriate therapeutic interventions are initiated before more serious adverse events occur. Special surgical populations, such as those patients who need perioperative anticoagulation, further benefit from a surgical team that includes a medical specialist. Expertise and close supervision throughout the perioperative period will give the hospitalized surgical patient the greatest chance for a quick and successful recovery.