Clinical trial NCT06693869: The Risk of Surgical Cancellation in Adult Patients Assessed by Telephone Versus In-person for Scheduled Non-cardiac Elective Surgery.
Official title: The Risk of Surgical Cancellation in Adult Patients Assessed by Telephone Versus In-person for Scheduled Non-cardiac Elective Surgery.
Study type: OBSERVATIONAL
Overall status: NOT_YET_RECRUITING
Conditions: Surgical Procedures
Telemedicine
Preanesthetic Medication
Preoperative Care
Anesthesia
Risk Assessment
Postoperative Complications
Noncardiac Surgery
Elective Surgery Cancellation
Keywords: Surgical Cancellation Risk
Preanesthetic Assessment
Telephone Preoperative Evaluation
In-Person Preoperative Evaluation
Elective Non-Cardiac Surgery
Surgery Cancellation Rate
Preanesthetic Evaluation Telemedicine
Telehealth in Preoperative Care
Comparison of Preanesthetic Methods
Risk Assessment for Surgery Cancellation
Postoperative Complications in Non-Cardiac Surgery
Patient Satisfaction with Telemedicine
Perioperative Outcomes
Remote Preoperative Consultation
Surgical Risk Management
Telemedicine vs. In-Person Evaluation
Retrospective Study in Anesthesiology
Surgical Outcome Prediction
Telemedicine in Anesthesiology
Preanesthetic Teleconsultation
Lead sponsor: Universidad de Antioquia
Sponsor class: OTHER
First posted: 2024-11-18
Enrollment: 1180
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: The study population includes adults aged 18 years and older scheduled for ambulatory elective non-cardiac surgeries at two healthcare institutions: Alma Mater Hospital of Antioquia and San Vicente Fundación University Hospital in Medellín.

Brief summary: Telemedicine has been regulated in Colombia since 2006, with applications in anesthesia being explored since 2004 to improve accessibility and reduce costs. Although Decree 538 of 2020 expanded telemedicine's medical applications, challenges such as connectivity issues and the need for training remain. Telemedicine has shown promise in rural areas of Colombia, particularly for managing chronic diseases. However, further evidence is needed regarding the effectiveness of telephone pre-anesthetic evaluations.

This study aims to investigate the implementation of telephone assessments for non-cardiac surgery and their impact on surgical cancellations compared to in-person pre-anesthetic evaluations. The primary question we seek to answer is:

Does telephone pre-anesthetic assessment in non-cardiac surgical patients carry a higher risk of surgical cancellations compared to in-person evaluations?

To address this question, we will evaluate patients' medical records in two hospitals where patients were assessed using both telephone and in-person modalities.

Detailed description: The COVID-19 pandemic accelerated the adoption of telemedicine, including its application in preoperative anesthesia evaluations. While the use of telephone assessments in anesthesiology is increasing, there is ongoing debate about their accuracy in identifying medical risks and predicting potential post-surgical outcomes. Preanesthetic evaluations are essential for determining patient suitability for surgery and for classifying surgical risk.

Despite the benefits of increased accessibility and cost reduction associated with telephone assessments, concerns persist regarding their ability to match the thoroughness of in-person evaluations. This is particularly relevant given the potential for higher surgical cancellation rates.

In Colombia, telephone preanesthetic evaluations for non-cardiac elective surgeries are a recent development, potentially optimising resource use and enhancing patient satisfaction. However, it is crucial to investigate whether they result in a cancellation rate comparable to in-person assessments, as this could be a significant barrier to widespread implementation. This study examines the effectiveness of telephone assessments for non-cardiac surgeries and their impact on surgical cancellations compared to in-person preanesthetic evaluations. A secondary objective of the study is to evaluate the incidence of perioperative complications, including cardiovascular issues, pulmonary complications, bleeding, unexpected ICU admissions, and non-anticipated difficult airways.

Eligibility criteria: Inclusion Criteria:

- Patients who were scheduled for elective non-cardiac surgery.

Exclusion Criteria:

* Pregnant patients.
* More than three months between the pre-anesthetic evaluation and the scheduled surgery.

Primary outcomes:
measure: Surgical cancellation incidence
timeFrame: Pre-surgery
Secondary outcomes:
measure: Incidence of unanticipated difficult airway
timeFrame: During the surgery
measure: Incidence of perioperative cardiovascular complications
timeFrame: Late postoperative (until 7 days after surgery)
measure: Incidence of postoperative mechanical ventilation
timeFrame: early postoperative (until 2 hours after surgery)
measure: Incidence of perioperative respiratory complications
timeFrame: Late postoperative (until 7 days after surgery)
measure: Incidence of unplanned ICU admission
timeFrame: early postoperative (until 2 hours after surgery)
Other outcomes:
Locations:
city: Medellin
country: Colombia
facility: University of Antioquia
state: Antioquia
city: Medellin
country: Colombia
facility: University of Antioquia
state: Antioquia
Study officials:
affiliation: Universidad de Antioquia
name: Fabian D Casas, Professor
role: STUDY_DIRECTOR
References:
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