Do Anesthesiologists Follow Belgian KCE Guidelines for Preoperative Evaluation?

Surgery Clinical Trial

Official title:

Do Anesthesiologists Follow Belgian KCE Guidelines for Preoperative Evaluation in Patients Undergoing Non-emergency Surgery ?

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05805124
• Other study ID #: SRB2023061
• Status: Completed
• Start date: August 1, 2023
• Est. completion date: August 29, 2023

Study information

• Verified date: March 2023
• Source: Erasme University Hospital
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

For more than 50 years it has been shown that preoperative evaluations by anesthesiologists include too many unnecessary tests. Many of the tests ordered do not change the management of the patients. One example are preoperative coagulation tests which rarely give relevant information and can be omitted if the patients have a negative structured bleeding questionnaire. This situation has lead to the publication of many guidelines on preoperative evaluation, one of the most comprehensive being the 2022 guidelines by the European Society of Cardiology for the preoperative evaluation of cardiac patients undergoing non-cardiac surgery.

In Belgium, an independent center of experts, the Kenniscentrum - Centre d'Expertise (KCE) was created to give expert and independent opinions on healthcare related subjects. These recommendations are often used by Belgian authorities to guide public health law and determine which medical procedures or tests are covered by the social security.

The KCE has published an extensive guide on preoperative evaluation of patients undergoing non-cardiac surgery (KCE Reports 280Bs. D/2016/10.273/102.) These guidelines are freely available, either in print version, on the dedicated Website or as an App, and have been extensively spread in the anesthesiology community. Laboratory tests not recommended in these guidelines are not covered by the social security if no solid reason is given in the medical chart.

In this retrospective study, adherence to the KCE guidelines on preoperative evaluations will be evaluated in a tertiary University hospital. All patients, scheduled for elective surgery, will be included for a period of 3 month. For every patient the recommended tests will be determined and compared to the actual tests prescribed by the anesthesiologist during the preadmission visit.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 2521
• Est. completion date: August 29, 2023
• Est. primary completion date: August 25, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• All patients examined at the anesthesiology preadmission clinic during Oct 1st 2022 and december 31st 2022 and scheduled for elective surgery at Erasme University hospital under general or locoregional anesthesia

Exclusion Criteria:

• Non elective surgery

• Age < 18 years

• surgery under local anesthesia

Related Conditions & MeSH terms

• Surgery

Intervention

Diagnostic Test:
• Preop evaluation
All preop evaluations prescribed in the preadmission clinic will be recorded, especially: renal function tests hematologic tests coagulation tests hepatic function tests ECG cardiac function tests pulmonary function tests endocrine function tests

Locations

Country	Name	City	State
Belgium	Hôpital Universitaire de Bruxelles - Hôpital erasme	Brussels

Sponsors (1)

Lead Sponsor	Collaborator
Erasme University Hospital

Country where clinical trial is conducted

Belgium, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Adherence to KCE recommendations in percentage	Every tests prescribed in the anesthesiology preadmission clinic will be compared to the KCE recommendations. Each test will be classified as "appropriate" or "not recommended". The percentage of adherence to the KCE guidelines will be reported for each test.	24 hours