Admass Biruk Adie, Ego Birhanu Yilma, Tawye Hailu Yimer, Ahmed Seid Adem
Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, P.O.Box: 196, Ethiopia.
Ann Med Surg (Lond). 2022 Sep 23;82:104777. doi: 10.1016/j.amsu.2022.104777. eCollection 2022 Oct.
Preoperative investigation for surgical patients is important to check for conditions that may affect surgical outcome. It helps the anesthetist and surgeon to plan perioperative anesthesia and surgical management appropriately. However, 60-70% of laboratory tests before surgery are not really required. This review was conducted to develop evidence-based recommendations on preoperative investigations for patients waiting for surgery in a resource limited setting.
After formulating the key questions, scope, and eligibility criteria for the articles to be included, advanced search strategy of electronic sources from data bases and websites was conducted. Duplication of literatures was avoided by endnote. Screening of literatures was conducted with proper appraisal. This review was reported in accordance with the preferred reporting items for systematic reviews and meta-analysis (PRISMA) 2020 statement.
A total of 553 articles were identified from data bases and websites using an electronic search. 75 articles were removed for duplication and 223 studies were excluded after reviewing titles and abstracts. At the screening stage, 82 articles were retrieved and evaluated for eligibility. Finally, 46 studies met the eligibility criteria and were included in this systematic review.
and recommendation: Selective laboratory ordering reduces the number and cost of investigations. Preoperative tests should be guided by the patient's clinical history, co-morbidities, and physical examination. Patients with signs or symptoms of certain types of disease should be evaluated with appropriate testing. Therefore, adherence to recommendations of guidelines on preoperative investigation is important for good surgical outcome and patient satisfaction.
对手术患者进行术前检查对于排查可能影响手术结果的状况至关重要。这有助于麻醉师和外科医生合理规划围手术期的麻醉和手术管理。然而，术前60% - 70%的实验室检查并非真正必要。本综述旨在针对资源有限环境下等待手术的患者的术前检查制定基于证据的建议。
在明确纳入文章的关键问题、范围及纳入标准后，对数据库和网站的电子资源进行了高级检索策略。通过EndNote避免文献重复。对文献进行筛选并进行适当评估。本综述按照系统评价和Meta分析的首选报告项目（PRISMA）2020声明进行报告。
通过电子检索从数据库和网站共识别出553篇文章。75篇因重复被剔除，223项研究在审阅标题和摘要后被排除。在筛选阶段，检索到82篇文章并评估其是否符合纳入标准。最终，46项研究符合纳入标准并被纳入本系统评价。
选择性的实验室检查医嘱可减少检查数量和费用。术前检查应以患者的临床病史、合并症和体格检查为指导。有特定类型疾病体征或症状的患者应进行适当检查评估。因此，遵循术前检查指南的建议对于取得良好的手术效果和患者满意度至关重要。
