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
FAQs
Find useful answers to important questions here.
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).
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) |
| ECG | Only 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 |
| Anaemia | Major surgery* with potential perioperative blood loss >500 ml | Routine lab tests, ferritin, transferrin saturation Patient blood management (PDF) |
| Oral anticoagulation | New oral anticoagulants (DOACs) | Weaning according to DOACs (PDF) |
| Vitamin K antagonists | Target 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 symptoms | ECG, cardiology opinion |
| CAD | Previous stenting | ECG, specialist report < 12 months old |
| Heart failure | With symptoms | ECG, electrolytes, recent echocardiography |
| Valve disease | If moderate to severe | Recent echocardiography |
| Pulmonary hypertension | All degrees of severity | Recent echocardiography |
| Hypertension | If not well controlled | ECG, optimise treatment if possible |
| Pacemaker/ICD | Report of last pacemaker check | |
| COPD/asthma | When there is clear impairment | Respiratory medicine opinion (lung function) |
| Chronic kidney disease | With a GFR < 60 ml/min | Recent electrolytes, creatinine, GFR |
| Liver disease | Viral hepatitis Alcoholic liver disease | Recent liver function tests, PT (Quick)/INR |
| Thyroid disease | With symptoms | Recent fT3/fT4, TSH |
| Coagulation disorders | Specialist report | |
| Cerebrovascular disease | Known arterial stenosis (carotid) | Vascular work-up (ultrasound) Neurological status if any neurological deficit |
| Allergies | Include 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 email, so that we can work together in an optimal manner.