Key result
Preoperative evaluation of 424 elective ear, nose, and throat surgery patients revealed an overall comorbidity rate of 21.2% and led to delayed surgery in 25.5% of cases.
Observational (n=424)
No
Preoperative evaluation in ENT surgery in a low-resource setting reveals significant comorbidities and abnormal lab results leading to delayed surgery in a quarter of patients.
Answers are grounded in this paper and cite their sources.
Routine preoperative labs flagged delays in 25% of low-resource ENT cases; leaves open whether selective testing safely reduces cancellations.
BACKGROUND: Routine laboratory investigations are important in preoperative preparation of otorhinolaryngological, head and neck patients to assess and to prevent operative risks. This study aimed at determining the American Society of Anesthesiologist (ASA) classification of the preoperative patients, causes of delayed surgery, associated comorbidity and abnormal laboratory investigation results in ear, nose, and throat surgical practice in a low-resource setting. MATERIALS AND METHODS: This is a prospective hospital-based study of patients being worked up for elective surgical procedures in Ekiti State University Teaching Hospital, Nigeria, from January 2014 to December 2016. Patients that gave consent were enrolled into the study. Interviewer-assisted questionnaires were used to obtained data from the patients. Data obtained were collated and statistically analyzed by using SPSS version 16. RESULTS: A total of 424 patients were enrolled into the study. Males constituted 61.8% and male to female ratio was 2:1. Majority, i.e. 69.8% of the patients belonged to the ASA Grade I. Preoperative findings leading to delayed surgery occurred in 17.9% of the patients. They were due to 2.4% arterial hypertension and 6.4% delayed routine laboratory investigations results. The overall comorbid illness was 21.2%. Major comorbid illnesses were 2.4% arterial hypertension and 6.8% diabetes mellitus. The types of surgery in the patients were 14.6% ear surgery, 12.3% nasal surgery, and 59.2% throat surgery. Delayed surgery occurred in 25.5% of the patients. The most common findings were 6.8% anemia, 6.3% abnormal prothrombin/international normalized ratio, and 5.7% blood electrolyte and urea. CONCLUSION: All surgical conditions are peculiar with different comorbid illnesses which can lead to untoward outcome. Adequate preoperative evaluation and preoperative laboratory investigation of ear, nose, and throat conditions are mandatory to detect subclinical illnesses in poor-resource setting.
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Olajide et al. (2018) conducted an observational in Elective otorhinolaryngological surgical procedures (n=424). Preoperative evaluation was evaluated on Causes of delayed surgery, associated comorbidity and abnormal laboratory investigation results. Preoperative evaluation of 424 elective ear, nose, and throat surgery patients revealed an overall comorbidity rate of 21.2% and led to delayed surgery in 25.5% of cases.
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