Perioperative care is the coordinated care surrounding surgery: before the operation, during it and through recovery afterward. It connects the decision to operate with preparation, the conduct of the procedure and subsequent assessment of recovery and complications. NICE’s enhanced-recovery recommendation explicitly includes preoperative, intraoperative and postoperative components.[ref]
Before an operation, relevant work includes assessing the person and procedure, communicating likely benefits and risks and supporting informed consent. During the operation, anaesthesia, physiological measurements and the surgical intervention must be coordinated. Afterward, responsibility continues through recovery, recognition of postoperative complications and follow-up. The professional statement of the American College of Surgeons treats postoperative responsibility and continuity as part of surgical care.[ref] A perioperative pathway therefore crosses professional and organizational boundaries rather than ending when the incision is closed.
Evaluating such a pathway requires defining both the outcome and the population followed. In an illustrative study, suppose 100 people are scheduled, 92 undergo the operation and 80 have a recorded follow-up outcome. If eight of those 80 have a specified postoperative complication, the observed rate among complete records is . Across all 92 operated people, the possible rate ranges from to , depending on the 12 missing outcomes. These are invented counts for a denominator example, not observed clinical rates.
The calculation shows why reporting only a recovery percentage can conceal important missing data. A comparison of care pathways also needs comparable case definitions, observation periods and patient characteristics. Measurements of pain, function, complications and use of resources describe different aspects of recovery; combining them into one endpoint changes the question being answered.
Perioperative care is consequently both clinical coordination and a problem of reliable measurement. A useful scientific account states what intervention changed, which stage of care it affected, who was observed and how the resulting clinical outcomes were assessed.
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