Surgical Health Optimization Center

Your Risk Factors

Obesity/BMI: Obesity is an epidemic in America with one in three adults being obese. If your BMI is over 30, then your weight is a major risk for complications after surgery. Being at or close to your ideal weight enhances your chances of surgical success. Weight loss is among the most important steps toward improving overall health and quality of life. In most cases, weight loss will improve the pain and loss of function associated with musculoskeletal pain. This improvement can be significant enough to prevent the need for surgery. If surgery is necessary, appropriate weight loss prior to surgery will dramatically reduce the risk of complications, including infection and dangerous blood clots. In addition, it will speed the recovery process and help prevent future problems. If your BMI is 30–39, you have an even higher risk of complications from surgery. If your BMI is 40 or above, you may not be a candidate for surgery.

Diabetes: Uncontrolled diabetes impairs healing and can increase the risk of postoperative infections. An HgA1c less than 8% promotes optimal outcomes after surgery. We can work with your primary care provider to optimize your diabetes plan to get your HgA1c lower prior to surgery. You may be asked to document your nutrition and discuss it with an advanced practice provider and health educator in order to ensure your protein intake is adequate. We recommend a daily multivitamin both before and after your surgery. Lab work may be necessary to check protein and blood sugar levels.

Sedentary Lifestyle: Most Americans report that they do little or no physical activity during a typical week. Over time, inactivity weakens your body’s ability to handle physical stress. Your surgery may put additional stress on your body, similar to a five mile run. Your heart, lungs and kidneys must be prepared for this physical test. Patients who walk at least 20 minutes daily prior to their surgery increase their cardiovascular and pulmonary strength to reduce the risk of heart attacks, stroke, and blood clots in the lung or legs.

Smoking: The nicotine in tobacco causes poor circulation to the body tissues, which delays the natural healing process that is needed to heal surgical incisions. Smokers have a four times higher chance of wound problems and post-operative pneumonia. Stopping smoking for a month prior to your surgery and one month after surgery will greatly improve your results. Your medical team will assist with smoking cessation aids, education and coaching.

Other: Your surgeon may identify other risk factors unique to your health and specific surgery. These risk factors may include preoperative anemia (low iron in your blood), protein malnutrition (prealbulmin is a blood marker of protein and indicates how well you will heal after surgery), or increased risk of delirium. Your prehabilitation team is ready to individually tailor your program to decrease your risk of complications following your surgery.