Kristoffersen Eirunn Wallevik, Fossum Mariann, Tveit Tor Oddbjørn, Berge Geir Thore, Hagen Milada Cvancarova, Opsal Anne
Department of Health and Nursing Science, University of Agder, Kristiansand, Agder, Norway
Department of Anaesthesiology, Sørlandet Sykehus HF, Kristiansand, Agder, Norway.
BMJ Open. 2025 Jun 12;15(6):e100922. doi: 10.1136/bmjopen-2025-100922.
To compare outcome data of hemicolectomy patients before and after the establishment of a preoperative anaesthesia assessment clinic (PAC).
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.
An acute care hospital in Norway.
A total of 612 patients undergoing elective open or laparoscopic hemicolectomy were included, of whom 338 (55.2%) had attended the PAC.
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.
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.
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.
NCT05520229.
比较术前麻醉评估诊所（PAC）设立前后半结肠切除术患者的结局数据。
本观察性研究通过回顾电子健康记录进行，涵盖PAC设立前（2014 - 2017年）和设立后（2017 - 2022年）两个时间段。
挪威的一家急症医院。
共纳入612例行择期开放或腹腔镜半结肠切除术的患者，其中338例（55.2%）曾就诊于PAC。
主要结局为计划手术的取消率，次要结局包括住院时间（LOS）、术中意外的麻醉相关事件以及术前患者病历中与麻醉计划相关的文件记录情况。
与PAC设立后的队列相比，PAC设立前的队列在数值上更有可能取消计划手术（OR = 1.97，95% CI（0.84至4.61）；p = 0.12）。PAC设立前的队列术中意外麻醉相关事件发生率（18.6%）在数值上也低于PAC设立后的队列（22.5%；p = 0.240）。然而，这些差异均无统计学意义。PAC设立后的队列中位住院时间（4.79天，IQR（3.80 - 6.12））显著短于PAC设立前的队列（5.16天（4.09 - 7.18）；p = 0.001）。此外，PAC设立后患者病历中与计划麻醉相关的文件记录明显更为常见。
PAC的设立降低了计划手术的取消率，但增加了术中麻醉事件的记录率。就诊于PAC的患者住院时间显著缩短，病历中有更多与麻醉相关的信息。
NCT05520229。
