Resumen

Background:The main goal of pre-operative laboratory screening is to detect individual patient risks and decrease perioperative complications. A careful assessment and rational use of these pre-operative tests are cost-effective. Although there is a recommended assessment protocol in our setting, the degree of adherence to this algorithm is variable. Aim:The aim of this study is to determine the degree of compliance with the existing algorithm for laboratory testing in patients undergoing outpatient laparoscopic cholecystectomy (oLC) in our institute, as a referral teaching hospital. Patients and Methods: We included 85 adult ASA-I patients with complete medical records who were programed for oLC with a minimal risk pre-operative assessment; 40 patients were included in the pre-intervention Phase (I) and 45, post-surgery (Phase III). The degree of adherence to the pre-operative algorithm was measured. The intervention phase (Phase II) consisted of targeted training required according to the audit findings. An App displaying the algorithm was developed for easing its adherence. Results: 73% of patients were female; the mean ± standard deviation (SD) age was 44.7 ± 14.8 years. Adherence was 92.5% in Phase I and 96% in Phase II. According to protocol studies were 63% while 36.5% were extra-protocol. The mean ± SD cost was 436.9 ± 594.7 MX pesos per patient. Post-operative complications occurred in 9 (10.6%) cases. Only 1 patient (1.2%) had a hospital stay longer than 5 days, due to a complication (mild pancreatitis). Conclusions: Adherence to the algorithm was >70.6% in Phase I and 98.5% in Phase III. There were >30% of studies outside of our protocol, with an approximate cost of 450 MX pesos per patient. The protocol algorithm for pre-operative tests in oLC should be emphasized for their rational and suitable use, thus lowering costs for both the patient and the institution.

Palabras clave: Laboratory tests laparoscopic cholecystectomy ambulatory surgery.

2017-12-19   |   250 visitas   |   Evalua este artículo 0 valoraciones

Vol. 10 Núm.1. Enero-Marzo 2017 Pags. 6-12 Hosp Medicin Clinic Manag 2017; 10(1)