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Preoperative management

Our aim is to achieve a smooth preoperative process, so that your patients are prepared for their forthcoming surgery as well as possible. The preoperative briefing session is a key element in this process.

As the referring physician, you know your patient best and can provide additional information that helps us to prepare for surgery and avoid repeated investigations. As a rule, you will receive the following documents concerning your patient within three to four days:

  • The report of the outpatient clinic visit
  • A copy of the preoperative assessment procedure

Please let us have your HIN email address so that we can send you the information as quickly as possible.

Contact

Please send the full documentation promptly by post to:

Balgrist University Hospital
Preoperative management
Forchstrasse 340
8008 Zurich

or by HIN mail to

Email (vorops@balgrist.ch)

Carry out some of the preoperative assessment yourself?

If you would like to carry out some of the preoperative assessment yourself in advance, we ask you to use the checklist below. So that all the key documents are available for the preoperative hospital appointment, please make sure that we have your assessment at least two working days before the examination of your patient. Send all the documents promptly by post or HIN mail (vorops@remove-this.balgrist.ch).

Preoperative assessment checklist

Diagnoses and medication

If possible, please send us a complete list of diagnoses and medications.

Lab test results and ECG for healthy patients

Lab tests Only for major surgery* with potential blood loss >500 ml and/or the patient is over the age of 65 Routine lab tests = full blood count, electrolytes, creatinine, GFR, PT (Quick)/INR (results not older than 3 months)
ECGOnly if the patient is over the age of 65

Additional investigations/lab tests in patients with pre-existing diseases and special conditions

Diagnosis / condition Criteria for additional investigation
Measure/ additional investigation
AnaemiaMajor surgery* with potential perioperative blood loss >500 mlRoutine lab tests, ferritin, transferrin saturation Patient blood management (PBM)
Oral anticoagulationNew oral anticoagulants (DOACs)Weaning according to DOACs
Vitamin K antagonistsTarget Quick value for operation > 65%; Bridging with LMWH
Reduced activity< 4 METs (4 METs: can perform light household tasks, climb 1-2 flights of stairs without stopping) Cardiology opinion
CAD With symptomsECG, cardiology opinion
CAD Previous stentingECG, specialist report < 12 months old
Heart failureWith symptomsECG, electrolytes, recent echocardiography
Valve diseaseIf moderate to severeRecent echocardiography
Pulmonary hypertensionAll degrees of severityRecent echocardiography
HypertensionIf not well controlledECG, optimise treatment if possible
Pacemaker/ICDReport of last pacemaker check
COPD/asthmaWhen there is clear impairmentRespiratory medicine opinion (lung function)
Chronic kidney diseaseWith a GFR < 60 ml/minRecent electrolytes, creatinine, GFR
Liver diseaseViral hepatitis Alcoholic liver disease Recent liver function tests, PT (Quick)/INR
Thyroid disease With symptomsRecent fT3/fT4, TSH
Coagulation disordersSpecialist report
Cerebrovascular diseaseKnown arterial stenosis (carotid)Vascular work-up (ultrasound) Neurological status if any neurological deficit
AllergiesInclude list or copy of allergy card

*Spondylodesis, all joint prostheses, revision surgery, pelvic surgery, tumour surgery, above and below knee amputations etc. Prior to any of these operations, we will take a further blood sample at the pre-admission check or on admission to hospital, for a current HemoCue® Hb, possibly CRP, and possibly PT (Quick)/INR.

Note on procedures carried out at short notice
If the patient requires surgery at short notice or there is insufficient time for you to perform the preoperative assessment, we regret that we will have to carry out this assessment ourselves. Please let us know particular concerns via vorops@remove-this.balgrist.ch, so that we can work together in an optimal manner.