Preoperative anaesthesia triage with a patient-centred system—A prospective clinical study
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Preoperative anaesthesia triage with a patient-centred system—A prospective clinical study. / Molin, Clara; Rovsing, Marie Louise; Meyhoff, Christian S.
In: Acta Anaesthesiologica Scandinavica, Vol. 64, No. 10, 2020, p. 1446-1452.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Preoperative anaesthesia triage with a patient-centred system—A prospective clinical study
AU - Molin, Clara
AU - Rovsing, Marie Louise
AU - Meyhoff, Christian S.
N1 - Publisher Copyright: © 2020 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd
PY - 2020
Y1 - 2020
N2 - 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.
AB - 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.
U2 - 10.1111/aas.13678
DO - 10.1111/aas.13678
M3 - Journal article
C2 - 32697850
AN - SCOPUS:85089007176
VL - 64
SP - 1446
EP - 1452
JO - Acta Anaesthesiologica Scandinavica
JF - Acta Anaesthesiologica Scandinavica
SN - 0001-5172
IS - 10
ER -
ID: 269499194