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Clinical audit of repeat fine needle aspiration in a general cytopathology service
Rachna Goyal1, Pankaj Kumar Garg2, Arati Bhatia1
1Department of Pathology, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India.
Background:
The few studies on repeat aspiration focussed on accuracy of diagnosis following repeat. Numbers and documented reasons for repeat remain unaddressed.
Aim:
To study factors associated with requests for repeat fine needle aspiration cytology (FNAC).
Settings And Design:
Metropolitan hospital, clinical audit.
Materials And Methods:
Audit of 5104 FNAC in 10 months.
Statistical Analysis Used:
Univariate, and multivariate binary logistic regression.
Results:
Seven hundred and six patients (13.8%) were advised repeat aspirates. Three hundred and twelve of these were actually repeated (44.1%). Carryover of actually repeated aspirates to subsequent months averaged 10.8 (34.2%). Maximum numbers of repeat requests were from thyroid 76/415 (18.3%), followed by lymph node 310/1856 (16.7%), and from breast 86/716 (12.0%). Outcome of actually repeated aspirates were: Diagnostic 181/312 (58.0%), and non-diagnostic 131/312 (41.9%). Reasons for repeat were inadequate aspirates 370/706 (52.4%), non-diagnostic descriptive reports 309/706 (43.7%); in 27/706 (3.8%), no reason was mentioned.
Conclusions:
Inadequate aspirates, non-diagnostic descriptive reports, and FNAC/FNAB from thyroid, lymph nodes, and breast contribute to repeats. We suggest steps to reduce the number of repeat aspirates to eliminate extra work.
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