How are patients with rheumatic diseases cleared for surgery?
The term “clearance” was used at a time when the goal of the preoperative assessment was to crudely divide patients into those able to tolerate surgery (“cleared”) and those unable to tolerate surgery. The term is largely historical as patients are uncommonly excluded from consideration for an operative procedure on the basis of their underlying medical conditions. However, patients with rheumatic diseases may be at increased risk for perioperative complications due to a variety of factors. A more appropriate goal of the preoperative assessment is risk stratification, with identification of potential perioperative problems whose risk can be reduced.