dc.contributor.author | Bharmal, Hassan | |
dc.date.accessioned | 2016-04-20T08:33:54Z | |
dc.date.available | 2016-04-20T08:33:54Z | |
dc.date.issued | 2015 | |
dc.identifier.uri | http://hdl.handle.net/11295/94347 | |
dc.description.abstract | BACKGROUND
Several studies and guidelines have recommended avoiding routine preoperative
testing in American Society of Anaesthesiologists (ASA) grade 1 and 2 patients undergoing
minor to moderate elective surgeries. However, most of these studies were conducted in
developed countries. At Kenyatta National Hospital, routine preoperative tests are done on
all patients undergoing elective surgery at the main theatre regardless of grade of surgery or
ASA grade. This study was done to find out if routine testing does actually reveal any
additional information other than findings on history and physical examination in our setup.
This data was used to determine if we can develop local guidelines similar to those in the
developed countries.
OBJECTIVE
To evaluate the usefulness of routine preoperative testing in ASA grade 1 and 2
patients undergoing minor to moderate elective surgeries at the main theatre at Kenyatta
National Hospital.
METHODOLOGY
A cross sectional study of 166 consenting ASA grade 1 and 2 patients undergoing
minor to moderate surgeries at the Kenyatta National Hospital main theatre was conducted
after approval from the University of Nairobi (UON) / Kenyatta National Hospital (KNH) Ethics
and Research Committee. The study was conducted over three and a half months. Data was
gathered using pre tested questionnaires on abnormal results, consequences of abnormal
results on immediate perioperative management and number of times preoperative tests are
conducted. Discrete variables were analyzed using percentages and frequencies while
continuous variables were analyzed using measures of central tendency. Results were then
compared to previous studies from developed countries using chi square, and p values
obtained.
10
RESULTS
The study reviewed preoperative tests of 166 patients. The mean age of the sample
was 40 years (SD 13), of which 55.4 % were male. 58.4 % were classified as ASA grade 1 while
93.4 % underwent a grade 2 surgery. Anaemia was prevalent in 6.6 % (p value 0.363) of the
patients, 6.6 % (p value 0.00001) had a leukocytosis, 3 % (p value 0.0092) had
thrombocytopenia, 4.8 % (p value 0.056) had an abnormal urea, 6.6 % (p value 0.00066) had
an abnormal creatinine and around 4 % (p value 0.0032) had an abnormal electrolyte level. 25
patients had a repeat test done, although all their tests were within normal range. Out of the
55 % patients who had an abnormality on their preoperative test only 4.2 % (p value 0.2615)
had their surgery postponed while 3 % had additional investigations.
CONCLUSION
The incidence of abnormal routine preoperative tests in our population is higher than
that in developed countries, however, the rate at which it impacts perioperative management
is not different. This study alludes to the possibility of developing local guidelines similar to
those from developed countries. | en_US |
dc.language.iso | en | en_US |
dc.subject | Relevance of routine preoperative testing in ASA grade 1 and 2 patients | en_US |
dc.title | Relevance of routine preoperative testing in ASA grade 1 and 2 patients undergoing minor to moderate elective surgeries at Kenyatta national hospital | en_US |
dc.type | Thesis | en_US |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |