Anesthesia, Elective Surgery Cancellation, Noncardiac Surgery, Postoperative Complications, Preanesthetic Medication, Preoperative Care, Risk Assessment, Surgical Procedures, Telemedicine
Conditions
Keywords
Surgical Cancellation Risk, Preanesthetic Assessment, Telephone Preoperative Evaluation, In-Person Preoperative Evaluation, Elective Non-Cardiac Surgery, Surgery Cancellation Rate, Preanesthetic Evaluation Telemedicine, Telehealth in Preoperative Care, Comparison of Preanesthetic Methods, Risk Assessment for Surgery Cancellation, Postoperative Complications in Non-Cardiac Surgery, Patient Satisfaction with Telemedicine, Perioperative Outcomes, Remote Preoperative Consultation, Surgical Risk Management, Telemedicine vs. In-Person Evaluation, Retrospective Study in Anesthesiology, Surgical Outcome Prediction, Telemedicine in Anesthesiology, Preanesthetic Teleconsultation
Brief summary
Telemedicine has been regulated in Colombia since 2006, with applications in anesthesia being explored since 2004 to improve accessibility and reduce costs. Although Decree 538 of 2020 expanded telemedicine's medical applications, challenges such as connectivity issues and training needs remain. Telemedicine has shown promise in rural areas of Colombia, particularly for managing chronic diseases. However, further evidence is needed regarding the effectiveness of telephone pre-anesthetic evaluations. This study aims to investigate the implementation of telephone assessments for non-cardiac surgery and their impact on surgical cancellations compared to in-person pre-anesthetic evaluations. The primary question to answer is: ¿Does telephone pre-anesthetic assessment in non-cardiac surgical patients carry a higher risk of surgical cancellations compared to in-person evaluations? To address this question, investigators will evaluate patients' medical records in two hospitals where patients were assessed using both telephone and in-person modalities.
Detailed description
The COVID-19 pandemic accelerated the adoption of telemedicine, including its application in preoperative anesthesia evaluations. While the use of telephone assessments in anesthesiology is increasing, there is ongoing debate about their accuracy in identifying medical risks and predicting potential post-surgical outcomes. Preanesthetic evaluations are essential for determining patient suitability for surgery and for classifying surgical risk. Despite the benefits of increased accessibility and cost reduction associated with telephone assessments, concerns persist regarding their ability to match the thoroughness of in-person evaluations. This is particularly relevant given the potential for higher rates of surgical cancellations. In Colombia, telephone preanesthetic evaluations for non-cardiac elective surgeries are a recent development that may optimize resource use and enhance patient satisfaction. However, it is crucial to investigate whether they lead to a cancellation rate comparable to that of in-person assessments, as this could be a significant barrier to widespread implementation. This study examines the effectiveness of telephone assessments for non-cardiac surgeries and their impact on surgical cancellations compared to in-person preanesthetic evaluations. A secondary objective of the study is to evaluate the incidence of perioperative complications, including cardiovascular issues, pulmonary complications, bleeding, unexpected ICU admissions, and non-anticipated difficult airways.
Interventions
None listed
Sponsors
Study design
Eligibility
Inclusion criteria
\- Patients who were scheduled for elective non-cardiac surgery.
Exclusion criteria
* Pregnant patients. * Hospitalized patients
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Surgical cancellation incidence | Pre-surgery | The incidence of surgical procedure cancellation because of a medical condition affecting the patient and the surgery. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of unanticipated difficult airway | During the surgery | Incidence of difficulties with facemask ventilation of the upper airway, tracheal intubation, or both. |
| Incidence of perioperative cardiovascular complications | Late postoperative (until 7 days after surgery) | Incidence of any perioperative cardiovascular complications during intraoperative or postoperative periods: all-cause death, sudden cardiac arrest, congestive heart failure, non-fatal myocardial infarction (MI), pulmonary embolism. |
| Incidence of postoperative mechanical ventilation | early postoperative (until 2 hours after surgery) | Incidence of postoperative mechanical ventilation. |
| Incidence of perioperative respiratory complications | Late postoperative (until 7 days after surgery) | The occurrence of respiratory complications in the perioperative period, including pneumonia, can happen within seven days following surgery |
| Incidence of unplanned ICU admission | early postoperative (until 2 hours after surgery) | Incidence of unplanned ICU admission in the postoperative |
Countries
Colombia
Contacts
Universidad de Antioquia