迪拉大学转诊医院手术患者术前检查结果异常的发生率、影响及相关因素:横断面研究。

IF 1.7 Q2 MEDICINE, GENERAL & INTERNAL Annals of Medicine and Surgery Pub Date : 2024-09-10 eCollection Date: 2024-10-01 DOI:10.1097/MS9.0000000000002567
Adamu Tesfaye, Robel Mesfine, Zenebe Bekele, Gemechu Mesgebu
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引用次数: 0

摘要

背景:作为术前评估的一个方面,术前检查通常是为了评估病人的医疗状况,以便进行风险分层和评估病人接受手术的状况。尽管实验室检查有助于确保最佳的术前状态,但常规筛查检查也有许多缺点。尽管有循证医学建议应进行哪些检查,但术前常规检查的传统仍然盛行,临床实践中发现异常结果的情况也各不相同:方法:11 月 1 日至次年 1 月,在迪拉大学转诊医院开展了一项基于机构的横断面研究。从完整的麻醉前检查表和已完成的检查中收集数据。在个人层面上,使用封闭式自我指导问卷收集数据。收集到的数据使用 SPSS 26 版进行输入、清理、编辑和检查,以进行数据处理和分析。对术前检查结果异常的影响进行了逻辑回归分析,并用表格和数字进行了总结。计算调整后的几率比(95% CI)以确定显著性水平:结果:分析了 208 名患者(65.9 名女性)的数据,平均年龄为(30.83±15.340)岁,体重指数为(22.59±2.99)。患者多为美国麻醉医师协会 I 级和 II 级患者,接受了国家临床与健康优化研究所的 2 级手术,手术形状为 3 级。共有 178 项(44.5%)检测结果异常。全血细胞计数是检测到最多的异常结果。只有 15 项(3.75%)异常对延迟、进一步检查和手术技术有影响。合并症(AOR 7.982,95% CI,P=0.041)、用药史(AOR 1.463,95% CI,P=0.013)、ASA 身体状况 II(AOR 3.287,95% CI,P=0.029)和吸烟史(AOR 1.577,95% CI,P=0.049)是与术前检查结果异常显著相关的因素:结论:在所有检查中,只有 0.6% 的检查对围手术期麻醉管理的改变有重大影响。结论:在所有检查中,只有 0.6% 对围手术期麻醉管理的改变有重大影响。
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Prevalence, impact and associated factors of abnormal preoperative investigation result in patients undergoing surgery in Dilla University referral hospital: cross-sectional study.

Background: As one domain of preoperative assessment, preoperative investigations are often ordered to evaluate patient's medical condition for risk stratification and assessing patient status to undergoing surgery. Despite the fact that laboratory testing can assist in ensuring the best possible preoperative condition, routine screening examinations have a number of drawbacks. Although there are evidence-based recommendations for which investigations should be done, the tradition of routine preoperative testing is still prevalent and clinical practice with abnormal results detected varies.

Method: Institution-based cross-sectional study design was conducted from 1 November to January at Dilla University Referral Hospital. Data was collected from complete pre-anaesthesia check-up sheets, investigations already done. It was collected at the individual level by using, closed-ended self-guided questionnaire. The collected data was entered, cleaned, edited and checked using SPSS version 26 for data processing and analysis. Logistic regression was performed to examine the impacts of abnormal preoperative investigation results and summarised by using tables and figures. An Adjusted odds ratio with 95% CI was computed to determine the level of significance.

Result: Data of 208 patients (65.9 female) with mean±standard deviation age 30.83±15.340 years and 22.59±2.99 BMI were analysed. Patients were mostly American Society of Anaesthesiologists I and II underwent National Institute of Clinical and Health Excellence Grade 2 surgeries and surgical shape class 3. Totally, 178 (44.5%) test results were abnormal. CBC is the most detected abnormal result. Only 15 (3.75%) abnormalities had an impact in terms of delay, further investigations, and surgical technique. Comorbidity (AOR 7.982, 95% CI, P=0.041), medication history (AOR 1.463, 95% CI, P=0.013), ASA physical status II (AOR 3.287, 95% CI, P=0.029) and history of smoking (AOR 1.577, 95% CI, P=0.049) were factors which was significantly associated with abnormal preoperative investigation result.

Conclusion: Only 0.6% of all tests had a significant impact in terms of changing perioperative anaesthetic management. The significant impact of abnormal investigation result noticed was delayed surgery.

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Annals of Medicine and Surgery
Annals of Medicine and Surgery MEDICINE, GENERAL & INTERNAL-
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5.90%
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