Researchers at University of Chicago Target Anesthesiology (Evaluation of Appropriate Use of Preoperative Echocardiography Before Major Abdominal Surgery: a Retrospective Cohort Study): Pain Medicine – Anesthesiology

Health Policy and Law Daily

2021 NOV 10 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- Current study results on Pain Medicine - Anesthesiology have been published. According to news originating from Chicago, Illinois, by NewsRx correspondents, research stated, “Preoperative resting echocardiography is often performed before noncardiac surgery, but indications for preoperative resting echocardiography are limited. This study aimed to investigate appropriateness of preoperative resting echocardiography using the Appropriate Use Criteria for Echocardiography, which encompass indications from the guidelines on perioperative cardiovascular evaluation and management and nonperioperative indications independent of the perioperative period.”

Financial support for this research came from NIH National Heart Lung & Blood Institute (NHLBI).

Our news journalists obtained a quote from the research from the University of Chicago, “The authors hypothesized that patients are frequently tested without an appropriate indication. Records of patients in the Truven Health MarketScan Commercial and Medicare Supplemental Databases who underwent a major abdominal surgery from 2005 to 2017 were included. These databases contain de-identified records of health services for more than 250 million patients with primary or Medicare supplemental health insurance coverage through employer-based fee-for-service, point-of-service, or capitated plans. Patients were classified based on the presence of an outpatient claim for resting transthoracic echocardiography within 60 days of surgery. Appropriateness was determined via International Classification of Diseases, Ninth Revision-Clinical Modification, and International Classification of Diseases, Tenth Revision-Clinical Modification principal and secondary diagnosis codes associated with the claims, and classified as ‘appropriate,’ ‘rarely appropriate,’ or ‘unclassifiable’ using the Appropriate Use Criteria for Echocardiography. Among 230,535 patients in the authors’ cohort, preoperative resting transthoracic echocardiography was performed in 6.0% (13,936) of patients. There were 12,638 (91%) studies classifiable by the Appropriate Use Criteria for Echocardiography, and 1,298 (9%) were unable to be classified. Among the classifiable studies, 8,959 (71%) were deemed ‘appropriate,’ while 3,679 (29%) were deemed ‘rarely appropriate.’ Surveillance of chronic ischemic heart disease and uncomplicated hypertension accounted for 43% (1,588 of 3,679) of ‘rarely appropriate’ echocardiograms. More than one in four preoperative resting echocardiograms were considered ‘rarely appropriate’ according to the Appropriate Use Criteria for Echocardiography.”

According to the news editors, the research concluded: “A narrow set of patient characteristics accounts for a large proportion of ‘rarely appropriate’ preoperative resting echocardiograms.”

This research has been peer-reviewed.

For more information on this research see: Evaluation of Appropriate Use of Preoperative Echocardiography Before Major Abdominal Surgery: a Retrospective Cohort Study. Anesthesiology, 2021;135(5):854-863. Anesthesiology can be contacted at: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA. (Lippincott Williams and Wilkins - www.lww.com; Anesthesiology - http://journals.lww.com/anesthesiology/pages/default.aspx)

The news correspondents report that additional information may be obtained from Daniel S. Rubin, University of Chicago, Dept. of Anesthesia and Critical Care, Box 428, Chicago, IL 60637, United States. Additional authors for this research include Allyson Tank, Robert Hughey, Peter Nagele and R. Parker Ward.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1097/ALN.0000000000003984. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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