Key result
Among patients presenting for surgery, 21% had comorbidities, leading to a day-of-surgery cancellation rate of 4.7% among those with comorbid illnesses despite prior review.
Why the study?
Surgical patients with inter-current medical diseases pose perioperative challenges, and suboptimal preoperative optimization can lead to surgery cancellation.
Observational (n=1,030)
No
Comorbidities, particularly hypertension, are common in surgical patients, but day-of-surgery cancellations due to these conditions are low (1%) when patients are preoperatively reviewed.
Highlights need for preoperative optimization to reduce cancellations in comorbid patients; leaves open effects on cardiac outcomes.
Globally patients with inter-current medical diseases are common place and are likely to present for anaesthesia and surgery at some point in their life. Surgical patients with inter-current medical diseases pose a great challenge to the anaesthetist; optimal perioperative care has to be provided to prevent adverse events, and thus reduce morbidity and mortality. Where preoperative optimization of the disease is not optimal, cancellation with its attendant consequencies becomes inevitable. This prospective observational study was carried out at the University of Abuja Teaching Hospital, Gwagwalada, Abuja between February 2018 and July 2018. All patients presenting for surgery at our general modular operating rooms formed the subjects of this study. A standardized questionnaire was used to document patient demographics, the presence and type of comorbidity, level of control of comorbidity, facility where care was being assessed for the inter-current illness, surgical diagnosis, nature of surgery and the decision or otherwise to proceed with the planned surgery. Questionnaires were administered pre induction on arrival at the Reception. A total of 215 (21%) patients had comorbidities. The cardiovascular system was the most affected, 55.8% and Hypertension (51.6%) was the most common comorbidity. There were a total of 10 (4.7%) cancellations. Cancellation was highest among the adult age group 70%, the female 80% and the Obstetric population 30%. Comorbidity is common among patients presenting for surgery. Cancellation of surgery on the day of surgery as a result of comorbidity despite preoperative review a day before surgery is possible though with a low incidence. Good preoperative review and optimization of the comorbidity will minimize this day of surgery cancellation.
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Felicia Asudo (2023) conducted an observational in Patients presenting for elective and emergency surgery (n=1,030). Comorbidities vs. No comorbidities was evaluated on Day of surgery cancellation due to comorbidity. Among patients presenting for surgery, 21% had comorbidities, leading to a day-of-surgery cancellation rate of 4.7% among those with comorbid illnesses despite prior review.