نقش ارزيابي قبل از عمل در كلينيك بيهوشي در كاهش ميزان لغو شدن اعمال جراحي انتخاب در روز عمل

The effect of anesthesia preoperative evaluation clinic on cancellation of elective surgery at operating day

Background: Adequate preoperative evaluation with sufficient informed consent from patients will lead to safe perioperative anesthetic managements. Recently anesthesiologist- directed preoperative evaluation clinics are used to prepare patients for the administration of anesthesia and surgery. Studies have shown that these clinics can reduce preoperative testing and consults, but few studies have examined the impact of the clinic on case cancellations at the day of surgery. We tested the impact of the visit to an anesthesia preoperative evaluation clinic (APEC) on case cancellations at the day of surgery. Materials and Methods: In a retrospective observational study, we evaluated the chart of 5765 elective cases operated during one year (1385) after starting visit to an anesthesia preoperative evaluation clinic (APEC). They were compared with 6067 cases under the previous system (during 1384). We examined the patients and obtained informed consents. Additional examinations and medications were ordered if necessary for adequate preoperative management. The impact of a clinic visit on case cancellation and delay in both sites were analyzed separately and compared. Results: A total of 11832 cases were included. 949 of 5765 (16.46%) APEC-evaluated patients were cancelled, as compared with 1325 of 6067 (21.83%) patients without a clinic visit (P= 0.000). In APEC-evaluated patients, cancellation due to "need for additional examinations and medications" significantly reduced. (20.3% in compare with 28% in non evaluated patients (p=0.000). Conclusions: An evaluation in the APMC can significantly reduce case cancellations and delays on the day of surgery and improve the quality control of patients before surgery.