Effectiveness Analysis of Anesthetic Preoperative Evaluation for Cardiac Patients

• Main Authors: Zih Jie Dai, 戴子傑
• Other Authors: H. I. Wang
• Format: Others
• Published: 2009
• Online Access: http://ndltd.ncl.edu.tw/handle/87592980093883245613

碩士 === 長庚大學 === 醫務管理學研究所 === 97 === Cardiovascular patients bear higher circulation system impacts during anesthesia. This research aims at understanding the association between Anesthetic Preoperative Evaluation (APE) and surgery cancellation and complications of cardiovascular patients conducting non-cardiovascular surgeries. Data were retrieved from anesthesia records of a medical center in northern Taiwan. In 2007 and 2008, there were 22086 cardiovascular patients planned to undergo non-cardiovascular surgeries, but 195 cancelled. Analyses found that patients who did not undergo APE exhibit higher cancellation rate at 1.11%, and the odds ratio is 1.83. A total of 21891 cardiovascular patients went through non-cardiovascular surgeries, but 82 developed unexpected complications during or after surgeries. Patients without APE were found to have higher complication rate at 0.79% and the odds ratios is 3.08. Logistic regression found that patients over the age of 65, non-emergency, planned general anesthesia and ASA II and above are more likely to cancel surgeries controlling other variants. However, only mid-risk and high-risk anesthesia patients were found to have higher complications during or after surgeries controlling other variants. The conclusion is that Anesthetic Preoperative Evaluation (APE) could effectively reduce surgery cancellations and complications during or after surgeries. It is suggested that administrative reinforcements be taken to fully exploit the functions of Anesthetic Preoperative Evaluation, and enhance patient safety.