Premium
The management of patients with ischaemic heart disease undergoing non‐cardiac elective surgery: A survey of Australian and New Zealand clinical practice
Author(s) -
Price D. J.,
Kluger M. T.,
Fletcher T.
Publication year - 2004
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2003.03656.x
Subject(s) - medicine , referral , blockade , beta blocker , risk stratification , perioperative , disease , emergency medicine , surgery , family medicine , heart failure , receptor
Summary Improvements in patient risk stratification and peri‐operative beta‐blockade have been suggested as methods which can reduce cardiovascular risk in patients with known cardiac risk factors. A postal questionnaire was sent to all Australian and New Zealand teaching hospitals to identify patterns of pre‐operative cardiac risk evaluation and methods of peri‐operative beta‐blocker use. In all, 67 replies were evaluated (64% response rate). Specialist anaesthetists are present in the majority of pre‐admission clinics (78%), with a designated peri‐operative physician in 9%. Further cardiological referral was possible in almost all institutions (96%), and specific peri‐operative physician referral in 54%. Waiting times for specialist consultation were < 7 days in the majority of cases. Whilst 79% of institutions used peri‐operative beta‐blockade, specific protocols were available in only 10%. In 60% of institutions, beta‐blockers were administered to high‐risk patients, and in 25% they were given to intermediate risk group patients. There was a wide range in the duration of pre‐ and postoperative beta‐blocker administration. Whilst peri‐operative risk assessment appears to be consistent, the pattern of beta‐blockade, a known beneficial intervention, is variable. Reasons need to be identified, protocols developed and consistent administration targeted for further improvements to be made.