ArticleBMJ open2023
Sensitivity of a preanaesthesia screening and triage tool in identifying high-risk patients attending the preanaesthesia assessment clinic in a tertiary referral hospital in Sub-Saharan Africa: a diagnostic accuracy study.
Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThe use of preoperative triage questionnaires is an innovative way to mitigate the shortage of anaesthesiologists and to identify and refer high-risk patients early for evaluation. This study evaluates the diagnostic accuracy of one such questionnaire in identifying high-risk patients in a Sub-Saharan population.
designDiagnostic accuracy study
settingThe study was conducted in a preanaesthesia assessment clinic in a tertiary referral hospital in Sub-Saharan Africa.
participantsThe study had a sample size of 128, including all patients above the age of 18 scheduled for elective surgery under any modality of anaesthesia other than local anaesthesia presenting to the preanaesthesia clinic. Patients scheduled for cardiac and major non-cardiac surgery and those non-literate in English were excluded. OUTCOME MEASURES: The sensitivity of the preanaesthesia risk assessment tool (PRAT) was the primary outcome measure. Other outcome measures were specificity, positive predictive value and negative predictive value.
resultsMajority of patients were young and women with a mean age of 36 referred for obstetric and gynaecological procedures. The sensitivity of the PRAT in identifying high-risk patients was at 90.6% with 95% CI (76.9 to 98.2) in this current study while the specificity, negative predictive value (NPV) and positive predictive value (PPV) were 37.5% with 95% CI (24.0 to 43.7), 92.3% with 95% CI (77.7 to 97.0) and 32.6% with 95% CI (29.6 to 37.3) respectively.
conclusionThe PRAT has a high sensitivity and may be used as a screening tool in identifying high risk patients to refer to the anaesthesiologist early before surgery. Adjusting the high risk criteria to fit the anaesthesiologists' assessments may improve the specificity of the tool.
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