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Module: Peri-operative Care in the Rural Setting

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Pre-Operative Cardio-respiratory Risk Assessment of the Obese Patient


Ashani Mahawattege (MBBS IV)

Faculty of Medicine
University of Adelaide

Mr Jon Shenfine
Consultant Oesophago-Gastric Surgeon
Royal Adelaide Hospital


Almost 38% of American adults are obese. This rate is steadily increasing and whilst the prevalence of obesity in Australia lags about ten percentage points behind, the rate of increase matches that of the States. More that 63% of Australian adults are overweight and of these, 28% are obese. Obesity and its attendant diseases is now one of the major health issues in Australia and other developed countries. Many of these patients will at some stage in their lives require surgical procedures, either as part of the management of the obesity itself, or something that is a consequence of their obesity, or perhaps a totally unrelated problem. Obesity per se is associated with an increased risk of intra and postoperative complications, hence a thorough preoperative assessment is imperative. This case explores the key aspects of history, physical examination, investigations and perioperative management in the obese patient during the preoperative assessment, with a focus on cardio-respiratory risk assessment.

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