Routine Para Clinic Evaluation Of Preoperative Patients: A New Solution For An Old Problem
Background: Routine Para clinic evaluation of preoperative patients tends to cause unnecessary costs, extra risk to the patients, inefficient operating room schedules and extra medico legal risk. Furthermore, it seldom affects clinician's preoperative evaluation and decision making process...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | fas |
| Published: |
Tehran University of Medical Sciences
2005-06-01
|
| Series: | Tehran University Medical Journal |
| Subjects: | |
| Online Access: | http://journals.tums.ac.ir/PdfMed.aspx?pdf_med=/upload_files/pdf/946.pdf&manuscript_id=946 |
| _version_ | 1818057608426160128 |
|---|---|
| author | Yaghoobi Notash A Fatemi SS |
| author_facet | Yaghoobi Notash A Fatemi SS |
| author_sort | Yaghoobi Notash A |
| collection | DOAJ |
| description | Background: Routine Para clinic evaluation of preoperative patients tends to cause unnecessary costs, extra risk to the patients, inefficient operating room schedules and extra medico legal risk. Furthermore, it seldom affects clinician's preoperative evaluation and decision making process for healthy patients. Numerous studies have shown that about 60% of these will not be performed if they are ordered according to recognizable indications based on history and physical examinations unfortunately the ‘indication based’ method can not replace to “routine” method due to difficulty and complexity to performing. Materials and Methods: We reviewed records of 1700 patients on a retrospective descriptive study in Sina Hospital from September 2000 to the end of September 2001. These patients had undergone general surgical procedures and were categorized as American society of anesthesiologists classification I or II. Results of complete blood count, fasting blood sugar, blood urea nitrogen, serum creatinin, sodium, potassium, chest X-ray, electrocardiogram and urinalysis were compared between patients under 40 years of age (n= 894) and patients aged 40 and over (n= 806). Results: Among 4935 tests performed in patients under 40 years of age, only 1004 (20.3%) were indicated, and treatment plan was not altered due to the results of routine tests in any case. In the other group, patients aged 40 and over, 6300 tests were performed, from which 3361 (53.3%) were indicated and treatment plans of 5 patients were influenced by the results of routine tests. Conclusion: Routine preoperative Para clinical tests is not cost effective method, otherwise the “indication based” also is difficult and complex method. We offer routine preoperative Para clinical tests only in patients over 40 years to combine ease of “routine” with a great reduction in medical costs and no adverse affect to patient care. |
| first_indexed | 2024-12-10T12:47:26Z |
| format | Article |
| id | doaj.art-de70ad3134aa4e949669df1deebd992b |
| institution | Directory Open Access Journal |
| issn | 1683-1764 1735-7322 |
| language | fas |
| last_indexed | 2024-12-10T12:47:26Z |
| publishDate | 2005-06-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Tehran University Medical Journal |
| spelling | doaj.art-de70ad3134aa4e949669df1deebd992b2022-12-22T01:48:22ZfasTehran University of Medical SciencesTehran University Medical Journal1683-17641735-73222005-06-01633188192Routine Para Clinic Evaluation Of Preoperative Patients: A New Solution For An Old ProblemYaghoobi Notash AFatemi SSBackground: Routine Para clinic evaluation of preoperative patients tends to cause unnecessary costs, extra risk to the patients, inefficient operating room schedules and extra medico legal risk. Furthermore, it seldom affects clinician's preoperative evaluation and decision making process for healthy patients. Numerous studies have shown that about 60% of these will not be performed if they are ordered according to recognizable indications based on history and physical examinations unfortunately the ‘indication based’ method can not replace to “routine” method due to difficulty and complexity to performing. Materials and Methods: We reviewed records of 1700 patients on a retrospective descriptive study in Sina Hospital from September 2000 to the end of September 2001. These patients had undergone general surgical procedures and were categorized as American society of anesthesiologists classification I or II. Results of complete blood count, fasting blood sugar, blood urea nitrogen, serum creatinin, sodium, potassium, chest X-ray, electrocardiogram and urinalysis were compared between patients under 40 years of age (n= 894) and patients aged 40 and over (n= 806). Results: Among 4935 tests performed in patients under 40 years of age, only 1004 (20.3%) were indicated, and treatment plan was not altered due to the results of routine tests in any case. In the other group, patients aged 40 and over, 6300 tests were performed, from which 3361 (53.3%) were indicated and treatment plans of 5 patients were influenced by the results of routine tests. Conclusion: Routine preoperative Para clinical tests is not cost effective method, otherwise the “indication based” also is difficult and complex method. We offer routine preoperative Para clinical tests only in patients over 40 years to combine ease of “routine” with a great reduction in medical costs and no adverse affect to patient care.http://journals.tums.ac.ir/PdfMed.aspx?pdf_med=/upload_files/pdf/946.pdf&manuscript_id=946Laboratory testsroutinepreoperative evaluationcost-effective |
| spellingShingle | Yaghoobi Notash A Fatemi SS Routine Para Clinic Evaluation Of Preoperative Patients: A New Solution For An Old Problem Tehran University Medical Journal Laboratory tests routine preoperative evaluation cost-effective |
| title | Routine Para Clinic Evaluation Of Preoperative Patients: A New Solution For An Old Problem |
| title_full | Routine Para Clinic Evaluation Of Preoperative Patients: A New Solution For An Old Problem |
| title_fullStr | Routine Para Clinic Evaluation Of Preoperative Patients: A New Solution For An Old Problem |
| title_full_unstemmed | Routine Para Clinic Evaluation Of Preoperative Patients: A New Solution For An Old Problem |
| title_short | Routine Para Clinic Evaluation Of Preoperative Patients: A New Solution For An Old Problem |
| title_sort | routine para clinic evaluation of preoperative patients a new solution for an old problem |
| topic | Laboratory tests routine preoperative evaluation cost-effective |
| url | http://journals.tums.ac.ir/PdfMed.aspx?pdf_med=/upload_files/pdf/946.pdf&manuscript_id=946 |
| work_keys_str_mv | AT yaghoobinotasha routineparaclinicevaluationofpreoperativepatientsanewsolutionforanoldproblem AT fatemiss routineparaclinicevaluationofpreoperativepatientsanewsolutionforanoldproblem |