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Clinical impact of preoperative respiratory syncytial virus testing
R C Manworren1, C Conner, M Myers
1Children's Medical Center of Dallas, USA.
Insights
Preoperative assessments cannot predict respiratory syncytial virus (RSV) infection in pediatric patients. However, a history of pulmonary disease and wheezing indicate a higher likelihood of surgery cancellation.
Area of Science:
- Pediatric Anesthesiology
- Infectious Diseases
- Surgical Outcomes
Background:
- Preoperative assessment is crucial for pediatric surgical patients.
- Predicting respiratory syncytial virus (RSV) infection and its impact on surgery is challenging.
- Identifying risk factors for surgery cancellation in pediatric patients is essential.
Purpose of the Study:
- To determine if preoperative physical examination and history can predict RSV infection in pediatric patients.
- To assess the predictability of surgery cancellations based on preoperative findings.
- To evaluate the association between preoperative assessment and adverse anesthetic outcomes.
Main Methods:
- Retrospective chart review of approximately 400 pediatric patients.
- Classification into groups based on RSV test results and surgery cancellation status.
- Statistical analysis including one-way ANOVA and Fisher's exact test.
Main Results:
- Preoperative history and physical findings alone did not predict active RSV infection.
- Patients with a history of pulmonary disease were more likely to have surgery cancelled.
- Wheezing during examination was also associated with increased surgery cancellation rates, irrespective of RSV status.
Conclusions:
- Preoperative assessment is insufficient to predict RSV infection in pediatric surgical patients.
- History of pulmonary disease and current wheezing are significant predictors of surgery cancellation.
- Further research may be needed to identify more accurate predictive markers for RSV and surgical outcomes.
Abstract:
The purpose of this study was to determine if preoperative assessment (i.e., physical examination and history review) of pediatric patients can predict positive test results for respiratory syncytial virus (RSV) infection, surgery cancellations, and adverse anesthetic outcomes. Approximately 400 pediatric patients were identified for the study from infection control statistics and classified by RSV test result and surgery cancellation status into three groups for analyses. Researchers analyzed retrospective chart data of preoperative histories and physical findings using one way analysis of variance to compare age among the groups and Fisher's exact test to compare patient characteristics and signs and symptoms of illness. The results show that active RSV infection cannot be predicted by history and physical findings alone. In addition, patients who had a history of pulmonary disease and who were wheezing at the time of their examinations were more likely to have their surgeries cancelled, independent of positive test results for RSV infection.