Effectiveness of non-cardiac preoperative testing in non-cardiac elective surgery : a systematic review
Elective surgery is usually preceded by preoperative diagnostics to minimize risk. The results are assumed to elicit preventive measures or even cancellation of surgery. Moreover, physicians perform preoperative tests as a baseline to detect subsequent changes. This systematic review aims to explore whether preoperative testing leads to changes in management or reduces perioperative mortality or morbidity in unselected patients undergoing elective, non-cardiac surgery. We systematically searched all relevant databases from January 2001 to February 2011 for studies investigating the relationship between preoperative diagnostics and perioperative outcome. Our methodology was based on the manual of the Ludwig Boltzmann Institute for Health Technology Assessment, the Scottish Intercollegiate Guidelines Network (SIGN) handbook, and the PRISMA statement for reporting systematic reviews. One hundred and one of the 25 281 publications retrieved met our inclusion criteria. Three test grid studies used a randomized controlled design and 98 studies used an observational design. The test grid studies show that in cataract surgery and ambulatory surgery, there are no significant differences between patients with indicated preoperative testing and no testing regarding perioperative outcome. The observational studies do not provide valid evidence that preoperative testing is beneficial in healthy adults undergoing non-cardiac surgery. There is no evidence derived from high-quality studies that supports routine preoperative testing in healthy adults undergoing non-cardiac surgery. Testing according to pathological findings in a patient's medical history or physical examination seems justified, although the evidence is scarce. High-quality studies, especially large randomized controlled trials, are needed to explore the effectiveness of indicated preoperative testing.
Medienart: |
E-Artikel |
---|
Erscheinungsjahr: |
2013 |
---|---|
Erschienen: |
2013 |
Enthalten in: |
Zur Gesamtaufnahme - volume:110 |
---|---|
Enthalten in: |
British journal of anaesthesia - 110(2013), 6 vom: 21. Juni, Seite 926-39 |
Sprache: |
Englisch |
---|
Beteiligte Personen: |
Johansson, T [VerfasserIn] |
---|
Links: |
---|
Anmerkungen: |
Date Completed 19.07.2013 Date Revised 02.12.2018 published: Print-Electronic Citation Status MEDLINE |
---|
doi: |
10.1093/bja/aet071 |
---|
funding: |
|
---|---|
Förderinstitution / Projekttitel: |
|
PPN (Katalog-ID): |
NLM226608824 |
---|
LEADER | 01000naa a22002652 4500 | ||
---|---|---|---|
001 | NLM226608824 | ||
003 | DE-627 | ||
005 | 20231224071816.0 | ||
007 | cr uuu---uuuuu | ||
008 | 231224s2013 xx |||||o 00| ||eng c | ||
024 | 7 | |a 10.1093/bja/aet071 |2 doi | |
028 | 5 | 2 | |a pubmed24n0755.xml |
035 | |a (DE-627)NLM226608824 | ||
035 | |a (NLM)23578861 | ||
040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
041 | |a eng | ||
100 | 1 | |a Johansson, T |e verfasserin |4 aut | |
245 | 1 | 0 | |a Effectiveness of non-cardiac preoperative testing in non-cardiac elective surgery |b a systematic review |
264 | 1 | |c 2013 | |
336 | |a Text |b txt |2 rdacontent | ||
337 | |a ƒaComputermedien |b c |2 rdamedia | ||
338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
500 | |a Date Completed 19.07.2013 | ||
500 | |a Date Revised 02.12.2018 | ||
500 | |a published: Print-Electronic | ||
500 | |a Citation Status MEDLINE | ||
520 | |a Elective surgery is usually preceded by preoperative diagnostics to minimize risk. The results are assumed to elicit preventive measures or even cancellation of surgery. Moreover, physicians perform preoperative tests as a baseline to detect subsequent changes. This systematic review aims to explore whether preoperative testing leads to changes in management or reduces perioperative mortality or morbidity in unselected patients undergoing elective, non-cardiac surgery. We systematically searched all relevant databases from January 2001 to February 2011 for studies investigating the relationship between preoperative diagnostics and perioperative outcome. Our methodology was based on the manual of the Ludwig Boltzmann Institute for Health Technology Assessment, the Scottish Intercollegiate Guidelines Network (SIGN) handbook, and the PRISMA statement for reporting systematic reviews. One hundred and one of the 25 281 publications retrieved met our inclusion criteria. Three test grid studies used a randomized controlled design and 98 studies used an observational design. The test grid studies show that in cataract surgery and ambulatory surgery, there are no significant differences between patients with indicated preoperative testing and no testing regarding perioperative outcome. The observational studies do not provide valid evidence that preoperative testing is beneficial in healthy adults undergoing non-cardiac surgery. There is no evidence derived from high-quality studies that supports routine preoperative testing in healthy adults undergoing non-cardiac surgery. Testing according to pathological findings in a patient's medical history or physical examination seems justified, although the evidence is scarce. High-quality studies, especially large randomized controlled trials, are needed to explore the effectiveness of indicated preoperative testing | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Research Support, Non-U.S. Gov't | |
650 | 4 | |a Review | |
650 | 4 | |a Systematic Review | |
650 | 4 | |a adult | |
650 | 4 | |a diagnostic tests, routine | |
650 | 4 | |a preoperative procedures | |
650 | 4 | |a review, systematic | |
650 | 4 | |a surgical procedures, operative | |
650 | 7 | |a Hemoglobins |2 NLM | |
650 | 7 | |a C-Reactive Protein |2 NLM | |
650 | 7 | |a 9007-41-4 |2 NLM | |
700 | 1 | |a Fritsch, G |e verfasserin |4 aut | |
700 | 1 | |a Flamm, M |e verfasserin |4 aut | |
700 | 1 | |a Hansbauer, B |e verfasserin |4 aut | |
700 | 1 | |a Bachofner, N |e verfasserin |4 aut | |
700 | 1 | |a Mann, E |e verfasserin |4 aut | |
700 | 1 | |a Bock, M |e verfasserin |4 aut | |
700 | 1 | |a Sönnichsen, A C |e verfasserin |4 aut | |
773 | 0 | 8 | |i Enthalten in |t British journal of anaesthesia |d 1946 |g 110(2013), 6 vom: 21. Juni, Seite 926-39 |w (DE-627)NLM000000310 |x 1471-6771 |7 nnns |
773 | 1 | 8 | |g volume:110 |g year:2013 |g number:6 |g day:21 |g month:06 |g pages:926-39 |
856 | 4 | 0 | |u http://dx.doi.org/10.1093/bja/aet071 |3 Volltext |
912 | |a GBV_USEFLAG_A | ||
912 | |a GBV_NLM | ||
951 | |a AR | ||
952 | |d 110 |j 2013 |e 6 |b 21 |c 06 |h 926-39 |