title: Global health implications of preanesthesia medical examination for ophthalmic surgery.
abstract: BACKGROUND
  Preanesthesia medical examination is a common procedure performed before ophthalmic surgery. The frequency and characteristics of new medical issues and unstable medical conditions revealed by ophthalmic preanesthesia medical examination are unknown. We conducted a prospective observational study to estimate the proportion of patients with new medical issues and unstable medical conditions discovered during ophthalmic preanesthesia medical examination. Secondary aims were to characterize abnormal findings and assess surgical delay and adverse perioperative events, in relation to findings.
  
  
  METHODS
  Patients having preanesthesia medical examination, before ophthalmic surgery, were enrolled over a period of 2 years. A review was conducted of historical, physical examination, and test findings from the preanesthesia medical examination.
  
  
  RESULTS
  From review of medical records of 530 patients, 100 patients (19%; 95% CI, 16-23%) were reported by providers to have abnormal conditions requiring further medical evaluation. Of these, 12 (12%) had surgery delayed. Retrospective review of examination results identified an additional 114 patients with abnormal findings for a total of 214 (40%; 95% CI, 36-45%) patients. Among the 214 patients, primary findings were cardiovascular (139, 26%), endocrine (26, 5%), and renal (24, 5%). Complications occurred in 49 (9%; 95% CI, 7-12%) patients within 1 month of surgery.
  
  
  CONCLUSIONS
  Ophthalmic preanesthesia medical examination frequently detects new medical issues or unstable existing conditions, which do not typically alter conduct of perioperative procedures or outcomes. However, these conditions are relevant to long-term patient health and should be conveyed to primary care physicians for further evaluation.
authors.affiliation: Mayo Clinic, Jacksonville, FL, USA. phillips.michael2@mayo.edu
authors.forename: Michael B
authors.initials: MB
authors.lastname: Phillips
authors.forename: Rick E
authors.initials: RE
authors.lastname: Bendel
authors.forename: Julia E
authors.initials: JE
authors.lastname: Crook
authors.forename: Nancy N
authors.initials: NN
authors.lastname: Diehl
mesh_terms: D000368:Aged; D000758:Anesthesia; D001794:Blood Pressure / Q000502:physiology; D002387:Cataract Extraction; D015897:Comorbidity; D003625:Data Collection; D003955:Diagnostic Tests, Routine; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D011300:Preoperative Care; D012189:Retrospective Studies; D012307:Risk Factors