The Risk of Surgical Cancellation in Adult Patients Assessed by Telephone Versus In-person for Scheduled Non-cardiac Elective Surgery.

Not yet recruiting

• Conditions: Surgical Procedures; Telemedicine; Preanesthetic Medication; Preoperative Care; Anesthesia; Risk Assessment; Postoperative Complications; Noncardiac Surgery; Elective Surgery Cancellation

• Registration Number: NCT06693869
• Lead Sponsor: Universidad de Antioquia

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.

Study Timeline

• Status Verified: 2024-11
• Study First Submitted: 2024-11-12
• Study First Submitted QC: 2024-11-15
• Last Update Submitted: 2024-11-15
• Study First Posted: 2024-11-18
• Last Update Posted: 2024-11-18
• Study Start: 2025-01-01
• Primary Completion: 2025-07-01
• Study Completion: 2025-11-01

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 1180

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.

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Surgical cancellation incidence	Pre-surgery	The incidence of surgical procedure cancellation because of a medical condition affecting the patient and the surgery.

Secondary Outcome Measures

Name	Time	Method
Incidence of unanticipated difficult airway	During the surgery	Incidence of difficulties with facemask ventilation of the upper airway, tracheal intubation, or both.
Incidence of perioperative cardiovascular complications	Late postoperative (until 7 days after surgery)	Incidence of any perioperative cardiovascular complications during intraoperative or postoperative periods: all-cause death, sudden cardiac arrest, congestive heart failure, non-fatal myocardial infarction (MI), pulmonary embolism.
Incidence of postoperative mechanical ventilation	early postoperative (until 2 hours after surgery)	Incidence of postoperative mechanical ventilation.
Incidence of perioperative respiratory complications	Late postoperative (until 7 days after surgery)	The occurrence of respiratory complications in the perioperative period, including pneumonia, can happen within seven days following surgery
Incidence of unplanned ICU admission	early postoperative (until 2 hours after surgery)	Incidence of unplanned ICU admission in the postoperative

Trial Locations

Locations (1)

University of Antioquia; 🇨🇴 Medellin, Antioquia, Colombia