Navigation Links
Pre-surgery exam rates vary widely among hospitals
Date:12/21/2011

TORONTO, Ont. -- Hospitals vary greatly in the number of patients who see an internal medicine specialist before major non-cardiac surgery, with rates ranging from five per cent of patients to 90 per cent, new research has found.

The findings are important because they suggest there are no commonly agreed upon standards for which patients should have such consultations, said Dr. Duminda Wijeysundera, a scientist at the Li Ka Shing Knowledge Institute of St. Michael's Hospital and the Institute for Clinical Evaluative Sciences (ICES).

As a result, some patients may be getting expensive tests and exams they don't need, while others who do need them are not getting them, said Dr. Wijeysundera, who is also an anesthesiologist at Toronto General Hospital-University Health Network.

Dr. Wijeysundera studied the records of 205,000 patients who underwent major elective non-cardiac surgery in 79 hospitals in Ontario from 2004 to 2009. His results were published today in the journal Anesthesiology.

All patients scheduled for elective surgery in Ontario must undergo a preoperative medical history and physical, which are typically done by the patient's family physician or surgeon. Referrals to an internal medicine specialist are usually made at the discretion of the surgeon or anesthesiologist.

One-third of the patients studied underwent a pre-operative medical consultation. Not surprisingly, most were older, were patients at teaching hospitals or hospitals with high volumes of surgery, or had other, pre-existing medical conditions such as diabetes or heart disease.

However, the rates varied widely from hospital to hospital, and could not be explained based on the surgical procedure, the volume of surgeries conducted at the hospital or whether it was a teaching hospital.

"That suggests the forces driving this have little to do with how sick the patient is," Dr. Wijeysundera said. "Further research is needed to better understand the basis for this inter-hospital variation and to determine which patients benefit most from pre-operative consultation."

More research is also needed to determine whether the difference may be explained by individual surgeon's preferences, he said.

Dr. Wijeysundera said pre-operative consultations may be helpful for patients with other medical issues, because it's an opportunity to document and/or treat those pre-existing conditions and take steps to lower their risks for surgery, or even cancel the procedure.

But previous studies have found no clear evidence that these consultations improve patient outcomes. In fact, the studies have suggested the tests and examinations may be associated with longer hospital stays, more post-operative complications and even a slightly higher death rate.

"When performed in patients who are unlikely to benefit from them, these consultations can increase healthcare costs, while exposing some individuals to unnecessary and potentially harmful tests or interventions," he said.


'/>"/>
Contact: Leslie Shepherd
shepherdl@smh.ca
416-864-6094
St. Michael's Hospital
Source:Eurekalert

Related medicine news :

1. Cholesterol-lowering medication accelerates depletion of plaque in arteries
2. Bone marrow and blood stem cell transplant survival rates equal, when donor is unrelated to patient
3. Survival rates increase with chemotherapy alone in patients with limited-stage Hodgkins lymphoma
4. NEJM publishes study showing LigoCytes norovirus vaccine demonstrates protection against illness
5. Asthma rates double for WTC first responders
6. AIDS Research Holds Promise for Reducing HIV Transmission Rates
7. Study demonstrates a connection between a common chemical and Parkinsons disease
8. Colon Surgery Linked to High Readmission Rates
9. New test for coronary artery disease linked to higher rates of cardiac procedures and greater costs
10. New hi-tech survey accelerates collection of vaccination data
11. Rates of breast reconstruction after mastectomy in Canada
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/24/2016)... , ... May 24, 2016 , ... ... family wealth and to housing, with more advantaged communities providing richer opportunities. Recognizing ... types of interventions: (a) school improvement policies; (b) school choice policies; (c) school ...
(Date:5/24/2016)... ... ... How to Write Error Free Procedures, **Presented by Ginette M. Collazo and ... known to be the major cause of quality and production losses in many industries. ... performance problems can be prevented. , How to Write Error Free Procedures, part two ...
(Date:5/24/2016)... ... ... Mental health watchdog Citizens Commission on Human Rights (CCHR) of ... Thomas Szasz, is continuing its protest against the use of electroshock (ECT) on children ... The opening of the exhibit follows CCHR’s recent protest at the annual convention of ...
(Date:5/24/2016)... , ... (PRWEB) May ... three new members of its Advisory Board. Joining the Grow ... Kusch. “All three of them embody the mission of our organization ... very fortunate to have them as we continue to expand our ...
(Date:5/24/2016)... ... May 24, 2016 , ... ... injury that focuses on repairing the musculoskeletal and neuromuscular systems of the human ... functional restoration, NYDNRehab began providing treatments for physical therapy in New York, including ...
Breaking Medicine News(10 mins):
(Date:5/24/2016)... May 24, 2016  Joe Marziani has joined VMS BioMarketing as senior vice president ... today. In his new role, Marziani will lead the company,s business development and sales ... improve outcomes. Photo - http://photos.prnewswire.com/prnh/20160523/371089 ... ... ...
(Date:5/24/2016)... May 24, 2016 Open Access ... Clinical Neurophysiology  Elsevier , a world-leading ... services, today announced the launch of Clinical ... journal that focuses on clinical practice issues in clinical ... clinical series, normal values and didactic reviews. It is ...
(Date:5/23/2016)... 2016 Global Paclitaxel Market 2016 ... 12 companies and the Paclitaxel analysis in this study ... industry and its players. This is the ... details the current state of the industry while providing ... applications and industry chain structure. The Paclitaxel market analysis ...
Breaking Medicine Technology: