评估如何明智地选择关于手术前心血管检测的建议
Keval Patel1, David Winchester2,3
1College of Medicine, University of Florida, Gainesville, FL, United States.
概括
在白内障手术前进行手术前的心血管检测是不常见的,很少异常,并且往往是不合理的. 这些发现表明需要修订"明智选择"对低价值护理的建议.
科学领域:
- 眼科医生 眼科 眼科
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- "明智选择"倡议建议在低风险手术前避免对无症状患者进行手术前检测.
- 白内障手术是一种常见的,低风险的外科手术程序,通常考虑在手术前进行测试.
研究的目的:
- 评估选择明智的建议对白内障手术的手术前检测的影响.
- 评估在接受白内障手术的患者中进行手术前检测的患病率和合理性.
主要方法:
- 在一个单一的学术医疗中心进行回顾性队列研究.
- 分析了2018年1月至2018年12月期间接受白内障手术的909名患者.
- 基于使用修订心脏风险指数 (RCRI) 的心脏风险分层进行的手术前检测率的比较.
主要成果:
- 只有9.9%的患者进行了手术前检测,心脏风险较高的患者 (15.9%) 与低风险患者 (6.7%) 的比率更高.
- 电心电图 (ECG) 构成了大部分订购的测试;异常结果是罕见的 (90次测试中有9次).
- 麻醉学临床医生订购了95.6%的测试,经常引用"例行"作为理由,无论心脏风险如何.
结论:
- 在白内障手术前进行手术前的心血管检测并不普遍,很少产生异常结果,并且经常没有充分的理由.
- 白内障手术显示,手术后心血管事件的发生率非常低.
- 结果支持修订明智选择建议,以解决在程序前检测中普遍存在的低价值护理领域.
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