English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Background: During preoperative preparation patients undergo investigations to detect asymptomatic diseases. The probability of finding significant abnormalities on such "routine" investigations is small, unnecessarily increasing costs of perioperative care. We evaluated current practices, compliance with guidelines and costs of preoperative investigations at the National Hospital of Sri Lanka (NHSL). Methods: Patients undergoing elective surgery at seven general surgical units of the NHSL from January- Februaary 2009 were included. NICE-UK guidelines on pre-operative investigation was the standard of assessment. Data on preoperative investigations were collected using an expert validated pre-tested interviewer administered questionnaire. A self-administered questionnaire was used to assess the ward practices and House Officers' (HOs) knowledge. Results: Sample size was 367. Mean age 45.7±15.8 years and males were 46.9%. Majority were ASA-I (68.7%) and surgical grade-II (56.7%). Urinalysis and arterial blood gases demonstrated good adherence (70%-100%) to guidelines. Electrocardiography, full blood count, renal function tests and blood grouping demonstrated moderate adherence (40-69%), all other investigations demonstrated poor adherence ( Conclusions: Unnecessary preoperative investigations are common at our institution leading to substantial excess costs. There is ample opportunity to rationalize practices and reduce expenditure Key words: Anaesthesia, audit; Surgery, preoperative period; Assessment, preanaesthetic DOI: 10.4038/slja.v18i1.1558 Sri Lankan Journal of Anaesthesiology 18(1): 29-35 (2010)

Preoperative investigations in elective surgery: practices and costs at the National Hospital of Sri Lanka