Current practice in the pre-operative assessment of patients for elective repair of abdominal aortic aneurysm. A survey of UK hospitals.
A postal survey of 100 hospitals throughout the United Kingdom and Ireland was conducted to assess current practice in the pre-operative assessment and use of pulmonary artery catheters in patients undergoing elective abdominal aortic aneurysm repair. Seventy-four completed questionnaires were received. The survey revealed that 53% of respondents hold designated preoperative assessment clinics, attended by anaesthetists in 54% and cardiologists in 26%. However, only 4% of respondents have a written protocol for stratifying patients and assessing peri-operative risk. By far the commonest investigation of choice for further cardiological assessment is transthoracic echocardiography (67%). Other investigations of choice are multiple update gated acquisition (MUGA) scan (13%), dipyridamole thallium imaging (9%), exercise ECG (6%), stress echocardiography (1%) and stress MUGA (1%). Two units (3%) never undertook further investigation. Pulmonary artery flotation catheters are used as a routine by 9% of respondents, dependent upon left ventricular ejection fraction by 65%, dependent on other factors by 7% and not used at all by 19%. The survey reveals widespread variation in pre-operative assessment of patients undergoing elective repair of abdominal aortic aneurysm.
Pullman
M D
MD
University Department of Anaesthetics, Northern General Hospital, Sheffield, UK.
Edwards
N D
ND
D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D006328:Cardiac Catheterization / Q000706:statistics & numerical data; D017023:Coronary Angiography / Q000706:statistics & numerical data; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data*; D017558:Elective Surgical Procedures; D006334:Heart Function Tests / Q000706:statistics & numerical data; D006801:Humans; D007494:Ireland; D010044:Outpatient Clinics, Hospital; D011364:Professional Practice; D011651:Pulmonary Artery; D011795:Surveys and Questionnaires; D006113:United Kingdom