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

NCT ID: NCT06693869

Last Updated: 2024-11-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Total Enrollment

1180 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-01-01

Study Completion Date

2025-11-01

Brief Summary

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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

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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.

Conditions

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

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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Telephone pre-anesthetic evaluation

Surgical patients scheduled for elective non-cardiac surgery underwent pre-anesthetic evaluation through a telephone consultation, which included a review of medical history, medications, and risk factors made by anesthesiologists. No physical examination was conducted.

No interventions assigned to this group

In-Person pre-anesthetic evaluation

Surgical patients scheduled for elective non-cardiac surgery received an in-person pre-anesthetic evaluation performed by an anesthesiologist, which included a physical examination and a thorough risk assessment.

No interventions assigned to this group

Eligibility Criteria

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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.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Universidad de Antioquia

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Fabian D Casas, Professor

Role: STUDY_DIRECTOR

Universidad de Antioquia

Locations

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University of Antioquia

Medellín, Antioquia, Colombia

Site Status

University of Antioquia

Medellín, Antioquia, Colombia

Site Status

Countries

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Colombia

Central Contacts

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Fabian D Casas, Professor

Role: CONTACT

+57 (604) 4441333

Esteban Gomez, Resident

Role: CONTACT

+57 (604) 4441333

Facility Contacts

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Fabian D Casas, Professor

Role: primary

057 (604)4441333

Fabian D Casas, Professor

Role: primary

057 (604)4441333

Fabian D Casas, Professor

Role: backup

Susana C Osorno, Professor

Role: backup

Esteban Gomez, Resident

Role: backup

Juan P Villegas, Resident

Role: backup

References

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Muñoz L, Reyes LE, Infante S, Quiroga J, Cabrera L, Obando N, et al. Cancelación de procedimientos electivos y su relación con la valoración preanestésica. Rev Repert Med Cir. 17 de abril de 2018;27(1):24-9.

Reference Type BACKGROUND

Thompson T, Brophy T, Modgil V, Pearce I. Remote healthcare consultations: the new era of outpatient medicine. Trends Urol Mens Health. 2020;11(5):25-8.

Reference Type BACKGROUND

Ryu S. Telemedicine: Opportunities and Developments in Member States: Report on the Second Global Survey on eHealth 2009 (Global Observatory for eHealth Series, Volume 2). Healthc Inform Res. junio de 2012;18(2):153-5.

Reference Type BACKGROUND

Prados Castillejo JA. [Telemedicine, also a tool for the family doctor]. Aten Primaria. 2013 Mar;45(3):129-32. doi: 10.1016/j.aprim.2012.07.006. Epub 2012 Sep 11. No abstract available. Spanish.

Reference Type BACKGROUND
PMID: 22981128 (View on PubMed)

Castillo VS, Cano CAG, Gonzalez-Argote J. Telemedicine and mHealth Applications for Health Monitoring in Rural Communities in Colombia: A Systematic Review.

Reference Type BACKGROUND

Aldawoodi NN, Muncey AR, Serdiuk AA, Miller MD, Hanna MM, Laborde JM, Garcia Getting RE. A Retrospective Analysis of Patients Undergoing Telemedicine Evaluation in the PreAnesthesia Testing Clinic at H. Lee Moffitt Cancer Center. Cancer Control. 2021 Jan-Dec;28:10732748211044347. doi: 10.1177/10732748211044347.

Reference Type BACKGROUND
PMID: 34644199 (View on PubMed)

Wongtangman K, Azimaraghi O, Freda J, Ganz-Lord F, Shamamian P, Bastien A, Mirhaji P, Himes CP, Rupp S, Green-Lorenzen S, Smith RV, Medrano EM, Anand P, Rego S, Velji S, Eikermann M. Incidence and predictors of case cancellation within 24 h in patients scheduled for elective surgical procedures. J Clin Anesth. 2022 Dec;83:110987. doi: 10.1016/j.jclinane.2022.110987. Epub 2022 Oct 26.

Reference Type BACKGROUND
PMID: 36308990 (View on PubMed)

Zhang K, Rashid-Kolvear M, Waseem R, Englesakis M, Chung F. Virtual preoperative assessment in surgical patients: A systematic review and meta-analysis. J Clin Anesth. 2021 Dec;75:110540. doi: 10.1016/j.jclinane.2021.110540. Epub 2021 Oct 11.

Reference Type BACKGROUND
PMID: 34649158 (View on PubMed)

Schmidt AP, Modolo NSP, de Amorim CG, Simoes CM, Kraychete DC, Joaquim EHG, Lineburger EB, Papa FV, Fernandes FC, Mendes FF, Guimaraes GMN, Barros GAM, Silva-Jr JM, Navarro E Lima LH, Azi LMTA, Carvalho LIM, Stefani LC, Garcia LV, Malbouisson LMS, Salgado-Filho MF, Nascimento Junior PD, Alves RL, Carvalho VH, Quintao VC, Carmona MJC. Two years of the COVID-19 pandemic: an anesthesiology perspective. Braz J Anesthesiol. 2022 Mar-Apr;72(2):165-168. doi: 10.1016/j.bjane.2022.02.004. Epub 2022 Feb 19. No abstract available.

Reference Type BACKGROUND
PMID: 35189166 (View on PubMed)

Kamdar NV, Huverserian A, Jalilian L, Thi W, Duval V, Beck L, Brooker L, Grogan T, Lin A, Cannesson M. Development, Implementation, and Evaluation of a Telemedicine Preoperative Evaluation Initiative at a Major Academic Medical Center. Anesth Analg. 2020 Dec;131(6):1647-1656. doi: 10.1213/ANE.0000000000005208.

Reference Type BACKGROUND
PMID: 32841990 (View on PubMed)

Lozada MJ, Nguyen JT, Abouleish A, Prough D, Przkora R. Patient preference for the pre-anesthesia evaluation: Telephone versus in-office assessment. J Clin Anesth. 2016 Jun;31:145-8. doi: 10.1016/j.jclinane.2015.12.040. Epub 2016 Apr 15.

Reference Type BACKGROUND
PMID: 27185698 (View on PubMed)

Garg R, Hoda W. Emergence of Telehealth for anesthesiologists in COVID-19-boon for all! J Anaesthesiol Clin Pharmacol. 2020 Jul-Sep;36(3):417-419. doi: 10.4103/joacp.JOACP_416_20. Epub 2020 Sep 29. No abstract available.

Reference Type BACKGROUND
PMID: 33487917 (View on PubMed)

Other Identifiers

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16-2024

Identifier Type: -

Identifier Source: org_study_id

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