Preoperative investigations for elective surgical patients in a resource limited setting: Systematic review

Admass, Biruk Adie; Ego, Birhanu Yilma; Tawye, Hailu Yimer; Ahmed, Seid Adem

doi:10.1016/j.amsu.2022.104777

Cited by 4 publications

(10 citation statements)

References 46 publications

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“…Generally, electrolytes and renal function tests are important for patients using diuretics who are exposed to nephrotoxic agents, have heart failure, have pituitary or adrenal disease, or experience major postoperative electrolyte alterations [ 8 , 25 ]. However, serum electrolyte levels are frequently assessed as a part of preoperative testing [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…ECG is regularly performed as one of the critical elements of standard preoperative evaluation and is recommended for patients suspected to have cardiac illnesses [ 6 , 8 ]. Our study found that only 2% of the patients had abnormal ECG findings.…”

Section: Discussionmentioning

confidence: 99%

“…We defined routine baseline investigations as those minimal tests administered to all patients regardless of disease, clinical findings, or comorbidities [ 7 , 8 ]. Laboratory test results were reported as normal and abnormal per their standard reference values [ 20 , 21 ].…”

Section: Methodsmentioning

confidence: 99%

“…Regular preoperative examinations requested in the absence of any specific clinical signs or purpose are intended to discover diseases or disorders in asymptomatic patients [ 2 ]. These groups of preoperative investigation usually include a panel of blood, urine tests, chest X-ray (CXR), electrocardiogram (ECG), and Doppler echocardiography (Echo) [ 2 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, no related complications or alterations in preoperative care have been recorded in patients with unforeseen abnormalities [ 12 ]. A recent systematic review found that preoperative testing based on the patient's clinical condition has financial benefits, without compromising patient safety and quality of healthcare [ 8 ]. Although many studies demonstrated the usefulness and cost-effectiveness of preoperative tests without clinical indication [ 2 , 15 ], these investigations are still routinely performed in many Saudi hospitals [ 16 - 18 ].…”

Section: Introductionmentioning

confidence: 99%

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The Incidence of Abnormal Preoperative Testing Among Elective Surgery Patients in a Referral Hospital in Southern Saudi Arabia

Alkhathami,

Alameer,

Alqarni

et al. 2024

Cureus

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Background Preoperative investigations are important to assess the clinical condition of patients who undergo elective surgical procedures. However, there is still debate about the usefulness of performing preoperative investigations. We aimed to determine the prevalence of routine preoperative investigation abnormalities among elective general surgery patients. Methodology This retrospective hospital-record-based study was conducted at the King Abdullah Hospital in Bisha Province, southern Saudi Arabia. General and clinical data of 968 patients who underwent elective surgical interventions from February 2022 to January 2023 were retrieved and analyzed. Result A total of 968 patients (578 females and 390 males) aged between 14 and 80 years were included in the study. Four hundred and eleven (42.5%) patients were in the age group of 40 years and above. The commonly detected comorbidities among the patients were diabetes (15%), hypertension (12%), respiratory diseases (7.5%), and cardiac diseases (2.5%). Abnormalities related to hemoglobin (31%), total leucocyte count (12.7%), and platelets (8.5%) were found in 968 patients. Around 15% of patients had increased creatinine levels. Hypokalemia was observed in 6.8% of patients. Increased liver enzymes were reported in limited proportions (10% to 14%) of patients. Slightly abnormal radiological findings were reported for chest X-ray (CXR) (2.8%), electrocardiogram (ECG) (2%), and Doppler echocardiography (Echo) (0.8%). A statistically significant association between the age of the patient and abnormal findings of ECG (p <.001), Echo (p = .001), and CXR (p <.001). Cardiac abnormalities were commonly associated with patients of ≥ 40 years. Abnormal cardiac findings (CXR, ECG, Echo) were significantly (p<.05) increased with the presence of diabetes, hypertension, and cardiovascular comorbidities. Conclusions Preoperative testing revealed limited proportions of abnormal findings among patients with elective surgical procedures. Routine ordering of many preoperative investigations without specifications may not predict postoperative complications of the patients. Therefore, undertaking preoperative testing should be guided by targeted history, physical examination, clinical risk factors, and type of surgical procedure intended to be performed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

The Incidence of Abnormal Preoperative Testing Among Elective Surgery Patients in a Referral Hospital in Southern Saudi Arabia

Alkhathami,

Alameer,

Alqarni

et al. 2024

Cureus

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Pre-anesthesia Evaluation and Risk Assessment in Adult Patient Candidates for Non-cardiac Surgery

Cataldo,

Migliorelli,

Agrò

2024

Practical Trends in Anesthesia and Intensive Care 2022

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Triple nerve transfers for the management of early unilateral facial palsy

Telich-Tarriba,

Navarro-Barquin,

Pineda-Aldana

et al. 2023

JPHS

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Background: Early onset facial paralysis is usually managed with cross-face nerve grafts, however the low number of axons that reach the target muscle may result in weakness or failure. Multiple-source innervation, or ‘supercharging’, seeks to combine the advantages of different donor nerves while minimizing their weaknesses. We propose a combination of cross-face nerve grafts with local extra-facial nerve transfers to achieve earlier facial reanimation in our patients.Methods: A retrospective cohort including all patients with early unilateral facial palsy (<12 months evolution) who underwent triple nerve transfer between 2019 and 2021 was conducted. We performed single-stage procedure including zygomatic-to-zygomatic and buccal-to-buccal cross-face grafts, a nerve-to-masseter to bucozygomatic trunk transfer, and a mini-hypoglossal to marginal branch transfer. Results were evaluated using the clinician-graded facial function scale (eFACE).Results: Fifteen patients were included (eight females, seven males), mean age at the time of surgery was 48.9 ± 13.3 years. Palsy was right-sided in eight cases. The mean time from palsy onset to surgery was 5.5 ± 2.8 months. Patients showed improvement in static (70.8 ± 21.9 vs. 84.15 ± 6.68, p = 0.002) and dynamic scores (20 ± 16.32 vs. 74.23 ± 7.46, p < 0.001), as well as periocular (57.33 ± 15.23 vs. 74 ± 7.18, p = 0.007), smile (54.73 ± 11.93 vs. 85.62 ± 3.86, p < 0.001), mid-face (46.33 ± 18.04 vs. 95 ± 7.21, p < 0.001) and lower face scores (67.4 ± 1.55 vs. 90.31 ± 7.54, p < 0.001).Conclusion: The triple nerve transfer technique using cross-face nerve grafts, the nerve-to-masseter, and the hypoglossal nerve, is an effective and reproducible technique to obtain middle and lower face reanimation in cases of early facial palsy.

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Preoperative investigations for elective surgical patients in a resource limited setting: Systematic review

Cited by 4 publications

References 46 publications

The Incidence of Abnormal Preoperative Testing Among Elective Surgery Patients in a Referral Hospital in Southern Saudi Arabia

The Incidence of Abnormal Preoperative Testing Among Elective Surgery Patients in a Referral Hospital in Southern Saudi Arabia

Pre-anesthesia Evaluation and Risk Assessment in Adult Patient Candidates for Non-cardiac Surgery

Triple nerve transfers for the management of early unilateral facial palsy

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