Prevalence and impact of abnormal routine pre-operative test results among elective surgical patients with or without co-morbidity: An observational comparative study

Rajaram, Narayanan; Karim, Habib Md Reazaul; Prakash, Avinash; Sahoo, Sarasa Kumar; Dhar, Mridul; Narayan, Anilkumar

doi:10.4103/npmj.npmj_34_18

Cited by 5 publications

(1 citation statement)

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“…Notably, most abnormal test results in routine preoperative tests do not change anaesthesia management 1 11-13 , even in oncological and older patients 14,15 . However, laboratory tests specific to the patient’s comorbid condition has an impact in changing the anaesthesia management 16 . Fourth, it reiterates that routine preoperative investigations are unnecessary and does not contribute to patient safety.…”

Section: Discussionmentioning

confidence: 99%

Information technology-based joint preoperative assessment, risk stratification and its impact on patient management, perioperative outcome, and cost

et al. 2021

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Background: Despite negative recommendations, routine preoperative testing practice is nearly universal. Our aim is to bring the healthcare providers on one platform by using information-technology based preanaesthetic assessment and evaluate the routine preoperative testing’s impact on patient outcome and cost. Methods: A prospective, non-randomised study was conducted in a teaching hospital during January 2019-August 2020. A locally developed software and cloud-computing were used as a tool to modify preanaesthesia evaluation. The number of investigations ordered, time taken, cost incurred, were compared with the routine practice. Further data were matched as per surgical invasiveness and the patient's physical status. Appropriate tests compared intergroup differences and p-value <0.05 was considered significant. Results: Data from 114 patients (58 in routine and 56 in patient and surgery specific) were analysed. Patient and surgery specific investigation led to a reduction in the investigations by 80-90%, hospital visit by 50%, and the total cost by 80%, without increasing the day of surgery cancellation or complications. Conclusion: Information technology-based joint preoperative assessment and risk stratification are feasible through locally developed software with minimal cost. It helps in applying patient and surgery specific investigation, reducing the number of tests, hospital visit, and cost, without adversely affecting the perioperative outcome. The application of the modified method will help in cost-effective, yet quality and safe perioperative healthcare delivery. It will also benefit the public from both service and economic perspective.

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Section: Discussionmentioning

confidence: 99%

Information technology-based joint preoperative assessment, risk stratification and its impact on patient management, perioperative outcome, and cost

et al. 2021

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Use of a Standardized Guideline to Optimize the Value of Preoperative Testing in Gynecological Surgery: A Pilot Study

Isaacson,

Buchele,

Cooney

et al. 2024

Journal of Gynecologic Surgery

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Exámenes preoperatorios en cirugías electivas no cardiacas de riesgo bajo e intermedio: revisión sistemática y análisis costo-efectividad

Meregildo-Rodríguez

2021

Horizmed

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Los exámenes preoperatorios son parte habitual en la práctica clínica. Sin embargo, su requerimiento no se sustenta siempre en la mejor evidencia científica. Cuando se solicitan sin justificación pueden generar resultados falsos positivos, la necesidad de repetir o solicitar nuevos exámenes e interconsultas, prolongar la estancia hospitalaria, ocasionar problemas al paciente (mayor riesgo, confusión y ansiedad) e incremento de los costos. Se realizó una revisión sistemática y análisis costo-efectividad de los exámenes preoperatorios en las cirugías electivas no cardíacas de riesgo bajo e intermedio más frecuentes realizadas en el Hospital Regional Lambayeque. Según el análisis costo-efectividad, el monto anual de los exámenes preoperatorios innecesarios sería de S/ 62 778, pero si se solicitaran de manera adecuada y se siguieran las pautas establecidas en la Guía NICE, este costo se reduciría en 38,34 % (es decir S/ 138,40 por cada paciente). Los resultados muestran que no se debe solicitar exámenes preoperatorios de manera rutinaria para las cirugías no cardíacas electivas de riesgo bajo e intermedio y que una minuciosa evaluación médica preoperatoria reduciría, de manera segura, la necesidad otras pruebas para este tipo de cirugías.

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Prevalence and impact of abnormal routine pre-operative test results among elective surgical patients with or without co-morbidity: An observational comparative study

Cited by 5 publications

References 0 publications

Information technology-based joint preoperative assessment, risk stratification and its impact on patient management, perioperative outcome, and cost

Information technology-based joint preoperative assessment, risk stratification and its impact on patient management, perioperative outcome, and cost

Use of a Standardized Guideline to Optimize the Value of Preoperative Testing in Gynecological Surgery: A Pilot Study

Exámenes preoperatorios en cirugías electivas no cardiacas de riesgo bajo e intermedio: revisión sistemática y análisis costo-efectividad

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