{"id":16748,"date":"2023-09-02T10:49:43","date_gmt":"2023-09-02T14:49:43","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=16748"},"modified":"2023-09-18T10:58:43","modified_gmt":"2023-09-18T14:58:43","slug":"association-of-preoperative-anaesthesia-consultation-prior-to-elective-noncardiac-surgery","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/association-of-preoperative-anaesthesia-consultation-prior-to-elective-noncardiac-surgery\/","title":{"rendered":"Association of preoperative anaesthesia consultation prior to elective noncardiac surgery with patient and health system outcomes: a population-based study"},"content":{"rendered":"<p><strong>Background<\/strong> \u2014 Surgical volumes and use of preoperative anaesthesia consultations are increasing. However, contemporary data estimating the association between preoperative anaesthesia consultation and patient (days alive and at home [DAH30], mortality) and system (costs, length of stay, and readmissions) outcomes are not available.<\/p>\n<p><strong>Methods<\/strong> \u2014 We conducted a population-based comparative effectiveness study using linked health administrative data among patients aged \u226540 yr who underwent intermediate-risk to high-risk elective, inpatient, noncardiac surgery in Ontario, Canada (2009\u201317). Our primary outcome was DAH30. Secondary outcomes included DAH90, 30-day and 1-yr mortality, 30-day health system costs, length of index admission, and 30-day readmissions. Propensity score overlap weights were used to adjust for confounders. Prespecified effect modifier analyses focused on high-risk subgroups.<\/p>\n<p><strong>Results<\/strong> \u2014 Among 364 149 patients, 274 365 (75.3%) received a preoperative anaesthesia consultation. No adjusted association was found (22.5 days vs 22.5 days; adjusted ratio of means 1.00, 95% CI 1.00\u20131.00) between consultation and DAH30 in the full population. We identified significant effect modification (significantly more DAH30) among patients with ischaemic heart disease, ASA physical status \u22654, frailty index score \u22650.21, and who underwent vascular surgery. Secondary outcomes were associated with preoperative consultation, including greater DAH90, decreased length of stay, lower 30-day and 1-yr mortality, and reduced 30-day costs.<\/p>\n<p><strong>Conclusions<\/strong> \u2014 Preoperative anaesthesia consultation was not associated with greater DAH30 across the overall study population. However, important potential benefits were observed among high-risk subgroups. Research is needed to identify optimal patient populations and consultation processes.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 Surgical volumes and use of preoperative anaesthesia consultations are increasing. However, contemporary data estimating the association between preoperative anaesthesia consultation and patient (days alive and at home [DAH30], mortality) and system (costs, length of stay, and readmissions) outcomes are not available. Methods \u2014 We conducted a population-based comparative effectiveness study using linked health [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[40,62,25],"migration-helper-qa-sample-set":[],"class_list":["post-16748","journal_article","type-journal_article","status-publish","hentry","topic-cardiovascular-disease","topic-health-services-research","topic-surgery"],"acf":{"citation":"Engel JS, Beckerleg W, Wijeysundera DN, Aucoin S, Leblanc J, Gagne S, Bryson GL, Lalu MM, Wyand A, McIsaac DI. <em>Br J Anaesth<\/em>. 2023; Sep 2 [Epub ahead of print].","source_url":"https:\/\/doi.org\/10.1016\/j.bja.2023.07.025","ices_scientist":[1319,1132],"site":[6734],"research_program":[6747],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Association of preoperative anaesthesia consultation prior to elective noncardiac surgery with patient and health system outcomes: a population-based study<\/title>\n<meta name=\"description\" content=\"Background \u2014 Surgical volumes and use of preoperative anaesthesia consultations are increasing. 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