Details

Autor(en) / Beteiligte

• Molin, Clara
• Rovsing, Marie Louise
• Meyhoff, Christian S.

Titel

Preoperative anaesthesia triage with a patient‐centred system—A prospective clinical study

Ist Teil von

• Acta anaesthesiologica Scandinavica, 2020-11, Vol.64 (10), p.1446-1452

Ort / Verlag

England: Wiley Subscription Services, Inc

Erscheinungsjahr

2020

Quelle

Wiley-Blackwell Journals

Beschreibungen/Notizen

• Background 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. Methods 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. Results 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 ASA III‐IV. Pre‐PAS reduced number of preanaesthetic visits by 39%. Pre‐PAS ≥ 1 had a sensitivity of 0.92 and a specificity of 0.46 for ASA III‐IV. Conclusions A patient‐centred preoperative triage system had high sensitivity for identifying ASA III‐IV, and multiple Pre‐PAS variables were associated with ASA III‐IV, but the model had low specificity. Pre‐PAS may guide triage of relevant patients to preanaesthetic visit.