Abstract

MELENDEZ, Héctor Julio; MORENO, Germán  and  ARTURO, Eduardo. Correlación entre exámenes solicitados en la consulta preanestésica y exámenes recomendados por SCARE, ASA Y NICE. Estudio de cohorte. Rev. colomb. anestesiol. [online]. 2005, vol.33, n.4, pp.219-236. ISSN 0120-3347.

The request or revision of paraclinical laboratory tests are realized with the objetive to identify and prove or disprove pathologies that can affect the perioperative management of patients. It is also focused on the evaluation of the responses during treatment scheme and to formulate specific and alternative plans for the optimal management of the patient. However, this should never be considered as a sifting exercise. More than 60% of the tests requested can be avoided if they are ordered under indications. The probability of finding abnormal results in a healthy patient is low and only a low percentage reveals abnormalities that could affect the perioperative management. Through a prospective cohort study, we intend to demonstrate the lack of correlation between the recommendations that scientific societies such as SCARE, ASA and NICE (National Institute for the Clinical Excellence,UK) , and the presurgical tests. The research was done in a multicentric form, involving 900 patients. A very low correlation is found in the investigation: 38% for SCARE, 31% for NICE and 28% for ASA. This includes, an excess of tests request greater than or equal to 60% in minor procedures and in patients without associated diseases. An average of six tests per patient were recorded. regardless of reporting abnormalities in 22% of the exams (149 patients), this only influenced in the postponement of one procedure. The anesthesiologist contributed only in the 0.15% of the cases and in 97.97% this was in head of the treating physician. There were projected over cost of over $45.000.000.00, therefore, it is necessary to share the recommendations amongst specialists as well as for anesthesiologists to exercise a more active role in this matter.

Keywords : Preoperative evaluation; Preoperative tests; ASA; NICE; SCARE.

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