Validity time of normal results of preoperative tests for surgical reintervention and the impact on postoperative outcomes
Validity time of normal results of preoperative tests for surgical reintervention and the impact on postoperative outcomes
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DOI：
10.1016/j.bjane.2017.10.005
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发表时间：
2018-04-01
影响因子：
1
通讯作者：
Góes, João Carlos Sampaio
中科院分区：
文献类型：
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作者：
Ramos, Lafayete William Ferreira;Souza, Cristiano F.;Góes, João Carlos Sampaio
背景和目的：很少有数据定义术前检查可以被认为有效的时间段。这项研究的目的是确定以前正常的术前检查结果随时间变化的可能性，以及这些变化对术后结果的影响。方法：纳入970例首次手术前检查正常的需要新的干预措施的患者。比较第一次手术和第二次手术的术前检查结果。评估了以下变量在检测结果中引起变化的可能性：性别、年龄、手术风险、既往化疗或放射治疗以及是否存在合并症。结果：中位手术间隔时间为27个月(6~84个月)。对于年龄<lt的患者，在12、24和36个月期间，至少一项术前检查的改变概率分别为1.7%(95%CI：0.5-2.9)、3.6%(95%CI：1.8-5.4)和6.4%(95%CI：3.9-8.9)；50岁和50岁患者分别为2.1%(95%CI：0.7-3.5)、9.2%(95%CI：5.9-12.5)和13.4%(95%CI：9.3-17.5)。年龄(p=0.009)、手术风险(p<；0.001)、化疗(p=0.001)、放疗(p=0.012)和合并症(p<；0.001)与检测结果改变的可能性有关。检查结果的改变与住院期间的不良结果无显著相关性(p=0.426)。结论：对于接受第二次手术的患者，在第一次手术干预后的第一年内，以前正常的术前检查结果发生改变的概率很低，当发生改变时，它们不会对住院术后结果产生不利影响。(C)2017年巴西航空工业公司。书名/作者Elsevier Editora Ltd.
Background and objective: There are few data defining the period of time in which preoperative tests can be considered valid. The purpose of this study was to determine the likelihood of changes in the results of preoperative tests previously normal in relation to time, and the impact of these changes on postoperative outcomes.Methods: A total of 970 patients with normal preoperative tests before the first surgery and who required a new intervention were included. The preoperative tests performed for the first procedure were compared with those performed for the second procedure. The following variables were assessed regarding their potential to induce changes in test results: sex, age, surgical risk, previous chemotherapy or radiotherapy, and presence of comorbidities. In-hospital outcomes were analyzed.Results: The median time between procedures was 27 months (6-84). The probability of change in at least one of the preoperative exams was 1.7% (95% CI: 0.5-2.9), 3.6% (95% CI: 1.8-5.4), and 6.4% (95% CI: 3.9-8.9) during the 12, 24, and 36-month intervals, respectively, for patients aged < 50 years and 2.1% (95% CI: 0.7-3.5), 9.2% (95% CI: 5.9-12.5), and 13.4% (95% CI: 9.3-17.5), respectively, for patients > 50 years of age. Age (p=0.009), surgical risk (p < 0.001), chemotherapy (p = 0.001), radiotherapy (p = 0.012), and comorbidities (p < 0.001) were associated with the likelihood of changes in test results. Test changes were not significantly associated with in-hospital adverse outcomes (p=0.426).Conclusion: For patients undergoing a second surgical procedure, the probability of change in previously normal preoperative tests is low during the first years after the first surgical intervention, and when changes occurred, they did not adversely affect the in-hospital postoperative outcomes. (C) 2017 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda.