An observational cohort study on pre-operative investigations and referrals: How far are we following recommendations?
Background and Aims: Pre-operative investigations are often required to supplement information for risk stratification and assessing reserve for undergoing surgery. Although there are evidence-based recommendations for which investigations should be done, clinical practice varies. The present study...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2016-01-01
|
| Series: | Indian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2016;volume=60;issue=8;spage=552;epage=559;aulast=Karim |
| _version_ | 1819213366756900864 |
|---|---|
| author | Habib Md Reazaul Karim Md Yunus Prithwis Bhattacharyya |
| author_facet | Habib Md Reazaul Karim Md Yunus Prithwis Bhattacharyya |
| author_sort | Habib Md Reazaul Karim |
| collection | DOAJ |
| description | Background and Aims: Pre-operative investigations are often required to supplement information for risk stratification and assessing reserve for undergoing surgery. Although there are evidence-based recommendations for which investigations should be done, clinical practice varies. The present study aimed to assess the pre-operative investigations and referral practices and compare it with the standard guidelines. Methods: The present observational study was carried out during 2014-2015 in a teaching institute after the approval from Institute Ethical Committee. A designated anaesthesiologist collected data from the completed pre-anaesthetic check-up (PAC) sheets. Investigations already done, asked by anaesthesiologists as well as referral services sought were noted and compared with an adapted master table prepared from standard recommendations and guidelines. Data were expressed in frequencies, percentage and statistically analysed using INSTAT software (GraphPad Prism software Inc., La Zolla, USA). Results: Seventy-five out of 352 patients (42.67% male, 57.33% female; American Society of Anesthesiologists physical status I to III) were included in this study. Nearly, all patients attended PAC with at least 5 investigations done. Of them, 89.33% were subjected to at least one unnecessary investigation and 91.67% of the referral services were not required which lead to 3.5 ( SD ±1.64) days loss. Anaesthesiologist-ordered testing was more focused than surgeons. Conclusion: More than two-third of pre-operative investigations and referral services are unnecessary. Anaesthesiologists are relatively more rational in ordering pre-operative tests yet; a lot can be done to rationalise the practice as well as reducing healthcare cost. |
| first_indexed | 2024-12-23T06:57:43Z |
| format | Article |
| id | doaj.art-bb6ef54284664170b1684b38e6246fa4 |
| institution | Directory Open Access Journal |
| issn | 0019-5049 |
| language | English |
| last_indexed | 2024-12-23T06:57:43Z |
| publishDate | 2016-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj.art-bb6ef54284664170b1684b38e6246fa42022-12-21T17:56:17ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50492016-01-0160855255910.4103/0019-5049.187783An observational cohort study on pre-operative investigations and referrals: How far are we following recommendations?Habib Md Reazaul KarimMd YunusPrithwis BhattacharyyaBackground and Aims: Pre-operative investigations are often required to supplement information for risk stratification and assessing reserve for undergoing surgery. Although there are evidence-based recommendations for which investigations should be done, clinical practice varies. The present study aimed to assess the pre-operative investigations and referral practices and compare it with the standard guidelines. Methods: The present observational study was carried out during 2014-2015 in a teaching institute after the approval from Institute Ethical Committee. A designated anaesthesiologist collected data from the completed pre-anaesthetic check-up (PAC) sheets. Investigations already done, asked by anaesthesiologists as well as referral services sought were noted and compared with an adapted master table prepared from standard recommendations and guidelines. Data were expressed in frequencies, percentage and statistically analysed using INSTAT software (GraphPad Prism software Inc., La Zolla, USA). Results: Seventy-five out of 352 patients (42.67% male, 57.33% female; American Society of Anesthesiologists physical status I to III) were included in this study. Nearly, all patients attended PAC with at least 5 investigations done. Of them, 89.33% were subjected to at least one unnecessary investigation and 91.67% of the referral services were not required which lead to 3.5 ( SD ±1.64) days loss. Anaesthesiologist-ordered testing was more focused than surgeons. Conclusion: More than two-third of pre-operative investigations and referral services are unnecessary. Anaesthesiologists are relatively more rational in ordering pre-operative tests yet; a lot can be done to rationalise the practice as well as reducing healthcare cost.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2016;volume=60;issue=8;spage=552;epage=559;aulast=KarimElective surgerypre-anaesthetic check-uppre-operative investigationpre-operative referralsroutine investigation |
| spellingShingle | Habib Md Reazaul Karim Md Yunus Prithwis Bhattacharyya An observational cohort study on pre-operative investigations and referrals: How far are we following recommendations? Indian Journal of Anaesthesia Elective surgery pre-anaesthetic check-up pre-operative investigation pre-operative referrals routine investigation |
| title | An observational cohort study on pre-operative investigations and referrals: How far are we following recommendations? |
| title_full | An observational cohort study on pre-operative investigations and referrals: How far are we following recommendations? |
| title_fullStr | An observational cohort study on pre-operative investigations and referrals: How far are we following recommendations? |
| title_full_unstemmed | An observational cohort study on pre-operative investigations and referrals: How far are we following recommendations? |
| title_short | An observational cohort study on pre-operative investigations and referrals: How far are we following recommendations? |
| title_sort | observational cohort study on pre operative investigations and referrals how far are we following recommendations |
| topic | Elective surgery pre-anaesthetic check-up pre-operative investigation pre-operative referrals routine investigation |
| url | http://www.ijaweb.org/article.asp?issn=0019-5049;year=2016;volume=60;issue=8;spage=552;epage=559;aulast=Karim |
| work_keys_str_mv | AT habibmdreazaulkarim anobservationalcohortstudyonpreoperativeinvestigationsandreferralshowfararewefollowingrecommendations AT mdyunus anobservationalcohortstudyonpreoperativeinvestigationsandreferralshowfararewefollowingrecommendations AT prithwisbhattacharyya anobservationalcohortstudyonpreoperativeinvestigationsandreferralshowfararewefollowingrecommendations AT habibmdreazaulkarim observationalcohortstudyonpreoperativeinvestigationsandreferralshowfararewefollowingrecommendations AT mdyunus observationalcohortstudyonpreoperativeinvestigationsandreferralshowfararewefollowingrecommendations AT prithwisbhattacharyya observationalcohortstudyonpreoperativeinvestigationsandreferralshowfararewefollowingrecommendations |