Serrano Aguilar P, López Bastida J, Duque González B, Pino Capote J, González Miranda F, Rodríguez Pérez A, Erdocia Eguía J
Servicio del Plan de Salud, Investigación y Evaluación de Tecnologías Sanitarias, Servicio Canario de Salud, Spain.
Rev Esp Anestesiol Reanim. 2001 Aug-Sep;48(7):307-13.
To analyze patterns of routine testing before elective/scheduled surgery in healthy/asymptomatic patients classified as ASA I or II according to the American Society of Anesthesiologists.
A questionnaire on the organization of preoperative testing was completed by anesthesiologists at five public hospitals in the Canary Islands. The questionnaire emphasized the most commonly ordered screening procedures, such as chest X-rays, electrocardiograms, laboratory tests and spirometry.
Red cell counts were most frequently requested (for 86% of the patients), followed by platelet counts (80%) and blood chemistry (75%) and coagulation studies (72%). Least requested were urine tests and spirometry. The frequencies of electrocardiogram and chest X-ray requests fell between the two extremes, with patient age and the presence of certain indications seeming to affect whether those tests would be ordered or not. The need for such screening was perceived to increase for patients over 40 years of age. The ordering of preoperative tests varied from hospital to hospital and among anesthesiologists at a single site in spite of established protocols.
Hospitals and individual anesthesiologists differ considerably in how they request preoperative tests. The variations can not be explained solely by differing patient needs given that respondents were contemplating only healthy/asymptomatic individuals undergoing relatively simple procedures.
分析根据美国麻醉医师协会分类为ASA I或II级的健康/无症状患者在择期/ scheduled手术前的常规检查模式。
加那利群岛五家公立医院的麻醉医师完成了一份关于术前检查安排的调查问卷。该问卷重点关注了最常进行的筛查程序,如胸部X光、心电图、实验室检查和肺活量测定。
红细胞计数的检查需求最为频繁(86%的患者),其次是血小板计数(80%)、血液化学检查(75%)和凝血研究(72%)。需求最少的是尿液检查和肺活量测定。心电图和胸部X光检查的需求频率处于这两个极端之间,患者年龄和某些指征的存在似乎会影响是否进行这些检查。40岁以上患者被认为更需要进行此类筛查。尽管有既定的方案,但术前检查的安排在不同医院以及同一医院的不同麻醉医师之间存在差异。
医院和个体麻醉医师在术前检查的要求方面存在很大差异。鉴于受访者仅考虑接受相对简单手术的健康/无症状个体,这些差异不能仅由不同的患者需求来解释。