在急诊科进行术前检查；一项临床审计。

Doing Pre-operative Investigations in Emergency Department; a Clinical Audit.

作者信息

Rafiq Muhammad Salman, Rafiq Maria, Rafiq Muhammad Imran, Salman Seema Gul, Hafeez Sania

机构信息

Department of Surgery, Khyber Teaching Hospital, Peshawar, Pakistan.

Department of Obstetrics and Gynecology, Khyber Teaching Hospital, Peshawar, Pakistan.

出版信息

Emerg (Tehran). 2017;5(1):e20. Epub 2017 Jan 9.

PMID:28286827

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5325889/

Abstract

INTRODUCTION

Pre-operative investigations for emergency surgical patients differ between centers. Following established guidelines can reduce unnecessary investigation, cost of treatment and hospital stay. The present audit was carried out to evaluate the condition of doing pre-operative investigations for three common surgical emergencies compared to National Institute for Health and Care Excellence (NICE) guidelines and local criteria.

METHODS

A retrospective clinical audit of acute-appendicitis, abscess and hernia patients admitted to the emergency department was carried out over a one-year period from July 2014 to July 2015. Data of laboratory investigations, their indication, cost and duration of hospital stay was collected and compared with NICE-guidelines.

RESULTS

A total of 201 patients were admitted to the emergency department during the audit period. These included 77(38.3%) cases of acute-appendicitis, 112 (55.7%) cases of abscesses, and 12 (6%) cases of hernia. Investigations not indicated by NICE-guidelines included 42 (20.9%) full blood counts, 29 (14.4%) random blood sugars, 26 (12.9%) urea tests, 4 (2%) chest x-rays, 13 (6.5%) electrocardiographs, and 58 (28.9%) urine analyses. These cost 25,675 Rupees (245.46 Dollars) in unnecessary investigation costs and 65.7 days of additional hospital stay.

CONCLUSIONS

Unnecessary investigations for emergency surgical patients can be reduced by following NICE-guidelines. This will reduce workload on emergency services, treatment costs and the length of hospital stay.

摘要

引言

各中心针对急诊手术患者的术前检查存在差异。遵循既定指南可减少不必要的检查、治疗费用和住院时间。本次审核旨在评估针对三种常见外科急诊进行术前检查的情况，并与英国国家卫生与临床优化研究所（NICE）指南及当地标准进行比较。

方法

对2014年7月至2015年7月期间急诊科收治的急性阑尾炎、脓肿和疝气患者进行为期一年的回顾性临床审核。收集实验室检查数据、其指征、费用和住院时间，并与NICE指南进行比较。

结果

审核期间共有201名患者入住急诊科。其中包括77例（38.3%）急性阑尾炎、112例（55.7%）脓肿和12例（6%）疝气。NICE指南未提及的检查包括42例（20.9%）全血细胞计数、29例（14.4%）随机血糖、26例（12.9%）尿素检测、4例（2%）胸部X光、13例（6.5%）心电图和58例（28.9%）尿液分析。这些不必要的检查费用为25,675卢比（245.46美元），额外住院时间为65.7天。