Preoperative anaesthesia triage with a patient-centred system-A prospective clinical study.

Acta Anaesthesiologica Scandinavica
Clara MolinChristian S Meyhoff

Abstract

Increase in day surgery has challenged preoperative anaesthesia with need to identify a few high-risk patients requiring detailed preoperative intervention. We aimed to assess if a nurse-administered Preoperative Patient-centred Anaesthesia System (Pre-PAS) could identify high-risk patients, defined as ASA score III-IV, before surgery and allow triage in standard preanaesthesia care. We hypothesized that Pre-PAS ≥ 1 would identify ASA III-IV patients with high specificity. We conducted a prospective study, where twelve preoperative risk factors were recorded before surgery with the Pre-PAS questionnaire along with a score from zero to twelve based on the number of positive criteria. Only patients with a Pre-PAS score ≥ 1 were followed by mandatory preoperative anaesthetists' assessment visit. Medical records were reviewed to ensure accurate ASA score evaluation, surgical cancellations and airway difficulties. Association between Pre-PAS score and ASA score was evaluated by Fisher's exact test. In a total of 487 included patients, 92% of high-risk patients (ASA III-IV) and 54% of low-risk patients (ASA I-II) had Pre-PAS score ≥ 1 (P ≤ .001). Nine out of 12 Pre-PAS criteria were significantly associated with higher frequency in A...Continue Reading

References

May 1, 1992·Journal of Clinical Anesthesia·R S TwerskyD Frank
Nov 5, 2002·Anaesthesia and Intensive Care·P H K MakUNKNOWN American Society of Anesthesiologists
Aug 13, 2003·Anaesthesia·W G HilditchS McGrane
Dec 3, 2003·Lancet·F J García-MiguelJ López-Bastida
Sep 3, 2011·European Journal of Anaesthesiology·Stefan De HertUNKNOWN Task Force on Preoperative Evaluation of the Adult Noncardiac Surgery Patient of the European Society of Anaesthesiology
Mar 16, 2012·Anaesthesia and Intensive Care·C GrantT B Corcoran
Feb 27, 2014·Tidsskrift for den Norske lægeforening : tidsskrift for praktisk medicin, ny række·Ole Jacob Møllerløkken
May 6, 2015·International Journal of Surgery·Nicholas J HackettJohn Y S Kim
Mar 4, 2017·Anesthesia and Analgesia·F Kayser EnnekingTerrie Vasilopoulos

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