A survey of pre-operative optimisation of high-risk surgical patients undergoing major elective surgery.
Pre-operative optimisation of high-risk patients undergoing major elective surgery has been shown to decrease peri-operative morbidity and mortality. It is also cost effective because of the resulting decrease in postoperative complications. A questionnaire was sent to 170 intensive care and high dependency units in Britain in order to quantify the number of units practising pre-operative optimisation. There was a 91% response rate. Of the respondents familiar with the evidence advocating pre-operative optimisation, 91% believe pre-operative optimisation improves outcome but only 62% admit patients for such preparation. Moreover, only eight units (6%) admit more than 25% of eligible patients. The reasons given for not admitting such patients pre-operatively are a lack of manpower, beds or both. This survey demonstrates the need for greater investment of resources into intensive care and high dependency units, so that clinicians can deliver high-quality evidence-based healthcare in accordance with the principles of clinical governance.
Singh
S
S
Department of Anaesthesia, Selly Oak Hospital, University Hospital NHS Trust, Birmingham B29 6JD, UK. sukbinder.singh@virgin.net
Manji
M
M
D017558:Elective Surgical Procedures / Q000592:standards*; D019538:Health Care Surveys; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods / Q000592:standards*; D011795:Surveys and Questionnaires; D006113:United Kingdom