Variation in the Practice of Preoperative Medical Consultation for Major Elective Noncardiac Surgery
Key result
Preoperative medical consultation was performed in 38% of patients undergoing major elective noncardiac surgery, with substantial interhospital variation (median odds ratio 3.51 between hospitals).
Why the study?
What factors determine the use of preoperative medical consultation for major elective noncardiac surgery, and how much does it vary across hospitals?
Study Design
Type
Cohort (n=204,819)
Multicenter
Yes
Structured PICO
What factors determine the use of preoperative medical consultation for major elective noncardiac surgery, and how much does it vary across hospitals?
P
Population
204,819 patients aged 40 years or older undergoing major elective noncardiac surgery across 79 hospitals in Ontario, Canada.
E
Exposure
Preoperative medical consultation
O
Outcome
Use of preoperative medical consultation and interhospital variation in consultation rates
Main Result
Odds Ratio: 3.51
There is substantial interhospital variation in the use of preoperative medical consultation for major noncardiac surgery that is largely driven by hospital-level practices rather than patient or surgical factors.
Authors
Discussion
No takes yet. Share an insight, caveat, or question.
Implication
Substantial interhospital variation in preoperative consultation use should not yet change referral patterns; leaves open whether standardizing hospital practices affects outcomes.
Cite This Study
Wijeysundera et al. (2011) conducted a cohort in Major elective noncardiac surgery (n=204,819). Preoperative medical consultation was evaluated on Preoperative medical consultation use (OR 3.51). Preoperative medical consultation was performed in 38% of patients undergoing major elective noncardiac surgery, with substantial interhospital variation (median odds ratio 3.51 between hospitals).