title: Preoperative evaluation: screening using a questionnaire.
abstract: OBJECTIVE
  Prior to elective surgery it is essential to know in advance the patient's clinical condition. The aim of this study was to compare the preoperative evaluation (POE) through questionnaire responses with preanesthetic evaluation by the anesthesiologist.
  
  
  METHODS
  Prior to their preoperative evaluation, patients answered a questionnaire with information regarding age, weight, height, scheduled surgery, past medical and surgical history, allergies, medications and doses used, social history (illicit drugs, alcohol, smoking), functional capacity and exercise tolerance. Preoperative evaluation was performed by an anesthesiologist who had no access to the questionnaire data or knowledge about the research. The questionnaire data were compared with the preoperative evaluation by two independent investigators, in order to answer the questions: 1) Was the questionnaire evaluation effective - could the patient undergo surgery without the need for face-to-face consultation? 2) Has been there any relevant information - ability to change the anesthetic approach - not assessed by the questionnaire, but assessed by the face-to-face consultation? 3) Has been there any information added by the health questionnaire that was missed by face-to-face consultation? For statistical analysis, the paired Student's t-test was used for parametric data and chi-square test for categorical data, with p < 0.05 considered significant.
  
  
  RESULTS
  Of the 269 eligible patients there was one refusal, and four agreed to participate but did not complete the questionnaire, in addition to 52 losses, totaling 212 participants. Questionnaire data added to the consultation in 109 cases (51.4%). The screening questionnaire alone was effective for 144 patients (67.93%), with no need for consultation. The anesthesiologist evaluation referred patients for surgery on their first visit in 178 opportunities (84%). In the identification of cases of non-referral to surgery, the questionnaire showed a negative predictive value of 94.4%, positive predictive value of 38.2%, sensitivity of 76.5%, and specificity of 76.4%. Statistically significant (P < 0.05) clinical factors associated with non-referral to surgery were: age over 65 years, BMI > 30, low functional capacity, hypertension, diabetes mellitus, asthma, renal failure, hepatitis, and ischemic heart disease.
  
  
  CONCLUSIONS
  The questionnaire was effective for screening patients who needed further evaluation and/or changes in treatment regimen prior to elective surgery. Moreover, the questionnaire added data not covered by clinical evaluation.
authors.affiliation: PhD, Santa Casa de São Paulo School of Medicine, Brazil; Centro de Ensino e Treinamento SBA-MEC-FCMPA, Irmandade Santa Casa de Misericórdia de Porto Alegre, Brazil; Resident Physician; Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil. Electronic address: men.men@terra.com.br.
authors.forename: Florentino Fernandes
authors.initials: FF
authors.lastname: Mendes
authors.affiliation: PhD; Anesthesiologist, Serviço de Anestesia Santo Antonio, Belo Horizonte, Minas Gerias, Brazil; Resident Physician; Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil.
authors.forename: Eduardo Lopes
authors.initials: EL
authors.lastname: Machado
authors.affiliation: Resident Physician; Resident Physician; Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil.
authors.forename: Maurício
authors.initials: M
authors.lastname: de Oliveira
authors.affiliation: Anesthesiologist; Fellowship at Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil; Resident Physician; Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil.
authors.forename: Fernando Rudem
authors.initials: FR
authors.lastname: Brasil
authors.affiliation: Resident Physician; Fellowship at Fundação Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil; Resident Physician; Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil.
authors.forename: Gibrahn
authors.initials: G
authors.lastname: Eizerik
authors.affiliation: Resident Physician; Fellowship at Fundação Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil; Resident Physician; Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil.
authors.forename: Patrick
authors.initials: P
authors.lastname: Telöken
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011795:Surveys and Questionnaires
keywords: Anesthesiology; Consultants; Preoperative Care; Questionnaires; Risk Factors