Analysis of Preoperative Test Screening in Patients Undergoing Elective Surgery at the Gynaecology Service of the ""Rafael Ángel Calderon Guardia"" Hospital during 2009
DOI:
https://doi.org/10.51481/amc.v52i3.660Keywords:
preoperative tests, gynaecologyAbstract
Aim: To analyze the use of routine preoperative tests in patients undergoing elective gynecologic surgery at the Rafael Ángel Calderón Guardia Hospital during 2009.
Methods: This is a cross-sectional observational study. Two hundred seventy two medical records were analyzed of patients who underwent surgery between January 1st 2009 and June 3rd of 2009.
The variables studied were: age, coexisting morbidity, amount and type of additional preoperative tests performed and amount and type of preoperative missing tests according to the 2002 guidelines of the American Society of Anaesthesiologists (ASA).
Results: The mean of preoperative tests preformed for each patient was 4,3 (SD + 2,1). According to the ASA guidelines, only 44,9% (CI: 95% 38,8-51,0) of the patients had all the preoperative test completed. In addition 55,1% (CI: 95% 49,0-61,2) of the patients missed at least 1 of the preoperative needed tests. The mean of the preoperative tests missing in this case was 1,7 (SD +1,1). On the other hand, 93% (CI: 95% 89,3-95,7) of the patients had undergone at least 1 unnecessary preoperative test according to their morbidity. The mean of this additional preoperative test was 2,5 (SD +1,6). Nine point five percent of the total of unnecessary preoperative tests showed abnormal results. Only 7,6% (CI: 95% 2,5-16,8) of the medical records of these patients showed some corrective action. Three percent (CI: 95% 0,4-10,5) of the surgeries were cancelled for this reason.
Conclusion: This study showed the incorrect use of preoperative tests in the Gynecology Service of the Calderón Guardia Hospital.
Downloads
References
Cohn S. The role of medical consultant. Med Clin N Am. 2003; 87: 1-6.
American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Practice advisory for preanesthesia evaluation: A report by the American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Anesthesiology. 2002; 96: 485-496.
Fleisher LA, Beckman JA, Brown KA, Calkins H, Chaikof EL, Fleischmann KE et al. ACC/AHA guidelines for preoperative cardiovascular evaluation and care for noncardiac surgery. J Am Coll Cardiol. 2007; 50: 159-241.
Lin PS. Preoperative evaluation. En: Vasilev SA ed. Perioperative and supportive care in gynecologic oncology. New York: Wile-Lyss; 2000: 289-302.
Macpherson DS. Preoperative laboratory testing: Should any test be ""routine"" before surgery? Med Clin N Am. 1993; 77: 289-308.
Fisher SP. Cost-effective preoperative evaluation and testing. Chest. 1999; 115 (Supplement): S96-S100.
Johnson BE, Porter J. Preoperative evaluation of the gynecologic patient. Obstet Gynecol. 2008; 111: 1183-1194.
Sweitzer BJ. Overview of preoperative evaluation and testing. En: Sweitzer BJ ed. Preoperative assessment and management 2a ed. Philadelphia: Lippincott Williams & Wilkins; 2008: 14-50.
Kaplan EB, Sheiner LB, Boeckmann AJ, Roizen MF, Beal SL, Cohen SN et al. The usefulness of preoperative laboratory screening. JAMA. 1985; 253: 3576-3581.
Blery C, Szatan M, Fourgeaux B, Charpak Y, Darne B, Chastang CL. Evaluation of a protocol for selective ordering of preoperative test. The Lancet. 1986; 139-141.
Macpherson DS, Snow R, Lofgren RP. Preoperative screening: Value of preoperative test. Ann Intern Med. 1990; 113: 969-973.
Chung F, Yuan H, Yin L, Vairavanathan S, Wong DT. Elimination of preoperative testing in ambulatory surgery. Anesth Analg. 2009; 108: 467-475.
Roizen MF. More preoperative assessment by physician and less by laboratory test. N Eng J Med. 2000; 342: 204-205.
Roizen MF. The compelling rationale for less preoperative testing. Can J Anaesth. 1988; 35:214-218.
Smetana GW, Macpherson DS. The case against routine preoperative laboratory testing. Med Clin N Am. 2003; 87: 7-40.
Downloads
Published
Issue
Section
License
Copyright (c) 2010 Acta Médica Costarricense

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Los autores que publican en la revista Acta Médica Costarricense pueden distribuir, copiar, remezclar, retocar, leer, descargar, imprimir, buscar y crear a partir de su obra de modo no comercial, indicando los créditos a la revista y sus autores y compartir su obra en las mismas condiciones. Para ello se aplica la licencia Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0 Internacional(CC BY-NC-SA 4.0)



