Tesfaye Adamu, Mesfine Robel, Bekele Zenebe, Mesgebu Gemechu
Dilla University, Dilla.
Ambo University, Ambo.
Ann Med Surg (Lond). 2024 Sep 10;86(10):5750-5755. doi: 10.1097/MS9.0000000000002567. eCollection 2024 Oct.
As one domain of preoperative assessment, preoperative investigations are often ordered to evaluate patient's medical condition for risk stratification and assessing patient status to undergoing surgery. Despite the fact that laboratory testing can assist in ensuring the best possible preoperative condition, routine screening examinations have a number of drawbacks. Although there are evidence-based recommendations for which investigations should be done, the tradition of routine preoperative testing is still prevalent and clinical practice with abnormal results detected varies.
Institution-based cross-sectional study design was conducted from 1 November to January at Dilla University Referral Hospital. Data was collected from complete pre-anaesthesia check-up sheets, investigations already done. It was collected at the individual level by using, closed-ended self-guided questionnaire. The collected data was entered, cleaned, edited and checked using SPSS version 26 for data processing and analysis. Logistic regression was performed to examine the impacts of abnormal preoperative investigation results and summarised by using tables and figures. An Adjusted odds ratio with 95% CI was computed to determine the level of significance.
Data of 208 patients (65.9 female) with mean±standard deviation age 30.83±15.340 years and 22.59±2.99 BMI were analysed. Patients were mostly American Society of Anaesthesiologists I and II underwent National Institute of Clinical and Health Excellence Grade 2 surgeries and surgical shape class 3. Totally, 178 (44.5%) test results were abnormal. CBC is the most detected abnormal result. Only 15 (3.75%) abnormalities had an impact in terms of delay, further investigations, and surgical technique. Comorbidity (AOR 7.982, 95% CI, =0.041), medication history (AOR 1.463, 95% CI, =0.013), ASA physical status II (AOR 3.287, 95% CI, =0.029) and history of smoking (AOR 1.577, 95% CI, =0.049) were factors which was significantly associated with abnormal preoperative investigation result.
Only 0.6% of all tests had a significant impact in terms of changing perioperative anaesthetic management. The significant impact of abnormal investigation result noticed was delayed surgery.
作为术前评估的一个领域,术前检查常常用于评估患者的身体状况,以进行风险分层,并评估患者接受手术的状态。尽管实验室检测有助于确保最佳的术前状态,但常规筛查检查存在诸多缺点。虽然对于应进行哪些检查有循证建议,但术前常规检查的传统仍然普遍存在,并且检测到异常结果后的临床实践各不相同。
于11月1日至1月在迪拉大学转诊医院进行基于机构的横断面研究设计。数据收集自完整的麻醉前检查表以及已完成的检查。通过使用封闭式自填问卷在个体层面收集数据。使用SPSS 26版本对收集到的数据进行录入、清理、编辑和检查,以进行数据处理和分析。进行逻辑回归以检查术前检查异常结果的影响,并通过表格和图表进行总结。计算调整后的比值比及95%置信区间以确定显著性水平。
分析了208例患者的数据(女性占65.9%),平均年龄±标准差为30.83±15.340岁,体重指数为22.59±2.99。患者大多为美国麻醉医师协会I级和II级,接受了英国国家卫生与临床优化研究所2级手术,手术切口分类为3类。总共178项(44.5%)检查结果异常。全血细胞计数是最常检测到的异常结果。只有15项(3.75%)异常在手术延迟、进一步检查和手术技术方面有影响。合并症(调整后的比值比为7.982,95%置信区间=0.041)、用药史(调整后的比值比为1.463,95%置信区间=0.013)、美国麻醉医师协会身体状况II级(调整后的比值比为3.287,95%置信区间=0.029)和吸烟史(调整后的比值比为1.577,95%置信区间=0.049)是与术前检查异常结果显著相关的因素。
所有检查中只有0.6%在改变围手术期麻醉管理方面有显著影响。注意到的检查结果异常的显著影响是手术延迟。