Procedure-specific Risk Factors

Every procedure elicits a stress-response, i.e., “surgical stress,” characterized by physiological (i.e., autocrine, endocrine, and paracrine) changes accompanied by psychological reactions (e.g., fear, anxiety, anger, tension, malaise or fatigue).¹¹ The magnitude of these procedure-related responses is proportional to the severity of tissue trauma, duration of the procedure, volume of blood loss, fluid shifts, and changes in core body temperature.¹¹

Based on the above criteria, procedure-related stress has been classified as high, intermediate, and low with estimated rates of associated major medical events of >5%, 1-5%, and <1%, respectively.¹² With low-stress procedures (e.g., dental procedures), the risk is negligible unless strong patient-specific risk factors are present. OHCP must identify patient-specific risk factors that may lead to medical emergencies during the perioperative period.