<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1409-0015</journal-id>
<journal-title><![CDATA[Medicina Legal de Costa Rica]]></journal-title>
<abbrev-journal-title><![CDATA[Med. leg. Costa Rica]]></abbrev-journal-title>
<issn>1409-0015</issn>
<publisher>
<publisher-name><![CDATA[Asociación Costarricense de Medicina Forense]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1409-00152016000200098</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Valoración preoperatoria: función anestésica]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Morales Castro]]></surname>
<given-names><![CDATA[Diana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Nacional de Seguros  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2016</year>
</pub-date>
<volume>33</volume>
<numero>2</numero>
<fpage>98</fpage>
<lpage>103</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S1409-00152016000200098&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S1409-00152016000200098&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S1409-00152016000200098&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: La valoración preoperatoria en nuestro país se ha convertido en la obtención de un visto bueno para una cirugía. La preparación de un paciente para cirugía requiere la comprensión del estado del paciente, la cirugía y los riesgos y alteraciones fisiológicas de cada técnica anestésica. Los pacientes sin valoración preoperatoria por un anestesiólogo tienen hasta siete veces mayor mortalidad, es por lo tanto pertinente que la valoración preoperatoria sea realizada por especialistas en esta área con conocimiento sobre las metas de la optimización perioperatoria de las comorbilidades y la disminución del riesgo quirúrgico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ Abstract: In our country the pre-surgery evaluation has become limited to an approval to perform it. Preparing a patient for surgery requires the understanding of its medical condition, surgery&#8217;s risks, and the physiological alterations of each anesthetics procedure. Patients without a pre-surgery evaluation by an anesthesiologist have seven times higher risk of death; it is pertinent that this evaluation be performed by specialists with knowledge on the perioperative optimization goals, on comorbidities, and decrease of the surgical risks.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Valoración properatoria]]></kwd>
<kwd lng="es"><![CDATA[anestesia]]></kwd>
<kwd lng="es"><![CDATA[cirugía]]></kwd>
<kwd lng="es"><![CDATA[riesgo quirúrgico]]></kwd>
<kwd lng="en"><![CDATA[Preoperative assesmnent]]></kwd>
<kwd lng="en"><![CDATA[anesthesia]]></kwd>
<kwd lng="en"><![CDATA[surgery]]></kwd>
<kwd lng="en"><![CDATA[surgery risk]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="">
<collab>The Association of Anaesthetists of Great Britain and Ireland</collab>
<source><![CDATA[Pre-operative Assessment and Patient Preparation. The Role of the Anaesthetist]]></source>
<year>2010</year>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Schweitzer]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Fahy]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Leib]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Rosenquist]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Perioperative Surgical Home: From Concept to Reality]]></article-title>
<source><![CDATA[Anesthesiolgy]]></source>
<year>2013</year>
<volume>77</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>58-9</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cohen]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Newman]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Weinstein]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Does preventive care save money? Health economics and the Presidential candidates]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>2008</year>
<volume>358</volume>
<page-range>661-3</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kain]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Vakharia]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Garson]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Engwall]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Schwarzkopf]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Gupta]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Cenneson]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Perioperative Surgical Home as a Future Perioperative Practice Model]]></article-title>
<source><![CDATA[Anesth Analg]]></source>
<year>2014</year>
<volume>118</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>1126-30</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<collab>American Society of Anesthesiologists Task Force on Preanesthesia Evaluation</collab>
<article-title xml:lang=""><![CDATA[Practice Advisory for Preanesthesia Evaluation]]></article-title>
<source><![CDATA[Anesthesiolog]]></source>
<year>2012</year>
<volume>116</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>1-17</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Findlay]]></surname>
<given-names><![CDATA[G. P]]></given-names>
</name>
</person-group>
<collab>National Confidential Enquiry into Patient Outcome and Death</collab>
<source><![CDATA[Knowing the Risk A review of the perioperative care of surgical patients]]></source>
<year>2011</year>
<publisher-name><![CDATA[NCEPOD]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<collab>ESA-ESICM Joint Task Force</collab>
<article-title xml:lang=""><![CDATA[Standards for definitions and use of outcome measures for clinical affectiveness research in perioperative medicine: European Perioperative Clinical Outcome (EPCO) definitions]]></article-title>
<source><![CDATA[EUR J anaesthesiol]]></source>
<year>2015</year>
<volume>32</volume>
<page-range>88-105</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Silber]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Rosenbaum]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Trudeau]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Zang]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Mosher]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Shoshan]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Changes in prognosis after the first posoperative complication]]></article-title>
<source><![CDATA[Med care]]></source>
<year>2005</year>
<volume>43</volume>
<page-range>122-31</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Shukri]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Henderson]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[De Palma]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Mosca]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Healey]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Kumbhani]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Determinants of long term survival after major surgery and the adverse effect of posoperative complications]]></article-title>
<source><![CDATA[Ann Surg]]></source>
<year>2005</year>
<volume>242</volume>
<page-range>326-43</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Silber]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Rosenbaum]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Trudeau]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Chen]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Zang]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Mosher]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Shoshan]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Changes in prognosis after the first posoperative complication]]></article-title>
<source><![CDATA[Med care]]></source>
<year>2005</year>
<volume>43</volume>
<page-range>122-31</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Kerridge]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Tong]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Hung]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Gin]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Perioperative Systems as a Quality Model of Perioperative Medicine and Surgical Care]]></article-title>
<source><![CDATA[Health Pol]]></source>
<year>2011</year>
<volume>102</volume>
<page-range>214-22</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="">
<collab>National Confidential Enquiry into Patient Outcome of Death</collab>
<source><![CDATA[Classification of intervention]]></source>
<year>2014</year>
</nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Melnyk]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Casey]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Black]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Koupparis]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Enhanced recovery after surgery protocols: Time to change practice?]]></article-title>
<source><![CDATA[CUAJ]]></source>
<year>2011</year>
<volume>5</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>342-8</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="">
<collab>NHS Improving Quality in collaboration with NHS England</collab>
<source><![CDATA[Enhanced Recovery Care Pathway: A better journey for patients seven days a week and better deal for the NHS]]></source>
<year>2013</year>
</nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="">
<collab>Department of Health NHS</collab>
<source><![CDATA[Enhanced Recovery Partnership Programme]]></source>
<year>2011</year>
</nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="">
<collab>Center for Medical Tecnology Policy</collab>
<source><![CDATA[Multi-stakeholder Agenda to Advance Enhanced Recovery for U.S. Surgical Patients]]></source>
<year>2014</year>
</nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kash]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Cline]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Menser]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Yichen]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
</person-group>
<source><![CDATA[Perioperative Surgical Home (PSH) A Comprehensive Literature Review for the American Society of Anesthesiologists. ASA]]></source>
<year>2014</year>
</nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Espinoza]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Navegando hacia un Modelo de Fast Track Surgery]]></article-title>
<source><![CDATA[Rev Chil Cir]]></source>
<year>2010</year>
<volume>62</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>219-20</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Adams]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Levenson]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Research Methods &amp; Reporting: Clinical Prediction Rules]]></article-title>
<source><![CDATA[BMJ]]></source>
<year>2012</year>
<volume>344</volume>
</nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Moonesinghe]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Myhten]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Das]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Rowan]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Groccot]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk stratification tools for predicting morbidity and mortality in adult patients undergoing major surgery]]></article-title>
<source><![CDATA[Anesthesiology]]></source>
<year>2013</year>
<volume>19</volume>
<page-range>959-81</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chand]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Armstrong]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Britton]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[How and why do we measure surgical risk]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Nash]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<source><![CDATA[J R Soc Med]]></source>
<year>2007</year>
<volume>100</volume>
<page-range>508-12</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[White]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Consent for Anesthesia]]></article-title>
<source><![CDATA[J Med Ethics]]></source>
<year>2004</year>
<volume>30</volume>
<page-range>286-90</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Moore]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[PRO: It is Past Time for a Separate Anesthesia Informed Consent Document]]></article-title>
<source><![CDATA[ASAS Article]]></source>
<year>2011</year>
<volume>75</volume>
<numero>7</numero>
<issue>7</issue>
</nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[O´Leary]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Informed Consent for Anesthesia: Has the time come for a separate written consent document?]]></article-title>
<source><![CDATA[ASA Newsletter]]></source>
<year>2006</year>
<volume>70</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>11-2</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kalantri]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Informed Consent and the Anaesthesiologist]]></article-title>
<source><![CDATA[Indian J. Anaesth]]></source>
<year>2003</year>
<volume>47</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>94-6</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>26</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Joseph]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Lloyd]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Kinnersley]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Cording]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Tomson]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Dodd]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Shared Decision Making: A Model for Clinical Practice]]></article-title>
<source><![CDATA[J Gen Intern Med]]></source>
<year></year>
<volume>27</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>1361-7</page-range></nlm-citation>
</ref>
<ref id="B27">
<label>27</label><nlm-citation citation-type="book">
<collab>Dirección de Vigilancia de la Salud Ministerio de Salud</collab>
<source><![CDATA[Análisis de Situación de Salud Costa Rica]]></source>
<year>2014</year>
<publisher-loc><![CDATA[San José, CR ]]></publisher-loc>
<publisher-name><![CDATA[MS]]></publisher-name>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
