Comparison of elective hemicolectomy patients before and after establishment of a preoperative anaesthesia assessment clinic: a retrospective, observational study in a hospital in Norway.

OBJECTIVES

To compare outcome data of hemicolectomy patients before and after the establishment of a preoperative anaesthesia assessment clinic (PAC).

DESIGN

This observational study was conducted retrospectively through an electronic health record review covering periods before (2014-2017) and after (2017-2022) the PAC was established.

SETTING

An acute care hospital in Norway.

PARTICIPANTS

A total of 612 patients undergoing elective open or laparoscopic hemicolectomy were included, of whom 338 (55.2%) had attended the PAC.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome was the rate of cancellation of planned surgeries, and the secondary outcomes were length of hospital stay (LOS), unanticipated intraoperative anaesthesia-related events and the presence of documentation relevant to the planning of anaesthesia in the patient's medical records preoperatively.

RESULTS

Compared with the after-PAC cohort, the before-PAC cohort was numerically more likely to have their planned surgery cancelled (OR=1.97, 95% CI (0.84 to 4.61); p=0.12). The before-PAC cohort also had a numerically lower rate of unanticipated intraoperative anaesthesia-related events (18.6%) than the after-PAC cohort (22.5%; p=0.240). However, neither of these differences was statistically significant. Median LOS was significantly shorter in the after-PAC cohort (4.79 days, IQR (3.80-6.12)) than in the before-PAC cohort (5.16 days (4.09-7.18); p=0.001). Moreover, the presence of documentation relevant to the planned anaesthesia in the medical records was significantly more common for after-PAC patients.

CONCLUSIONS

The establishment of the PAC reduced the rate of planned surgery cancellations but increased the rate of recorded intraoperative anaesthesia events. Patients who attended the PAC had a significantly shorter LOS and more anaesthesia-related information in their medical records.

TRIAL REGISTRATION NUMBER

NCT05520229.