First Author: R.Bendel USA
Co Author(s): M. Phillips
Purpose:
Preanesthesia Medical Examination (PAME) is a common procedure performed prior to cataract surgery. We conducted a prospective study to estimate the proportion of patients with new medical issues and unstable medical conditions discovered during ophthalmic PAME. Secondary aims were to characterize the abnormal findings, and to assess surgical delay and adverse perioperative events in relation to PAME findings.
Setting:
Mayo Clinic Foundation, Jacksonville, Florida, USA. A large comprehensive medical center.
Methods:
Patients undergoing PAME prior to ophthalmic surgery were enrolled over a period of 2 years. A review was conducted of all historical, physical examination, and test findings from the PAME.
Results:
On review of medical records of 410 patients, 77 patients (19%) were reported by PAME providers to have abnormal conditions requiring further medical evaluation (95% confidence interval [CI], 16 to 23%). Careful retrospective review of the PAME results identified an additional 88 patients with abnormal findings for a total of 165 (40%, 95% CI, 36 to 45%) patients. Among the 410 patients, the 3 primary areas of findings were: cardiovascular (108, 26%), endocrine (17, 4%), pulmonary (17, 4%) and renal (18, 4%). Surgery was delayed due to PAME in 17 (4%) patients. Adverse events occurred in 37 patients (9%, 95% CI, 7 to 12%) patients within 1 month of surgery.
Conclusions:
Ophthalmic PAME frequently detects new medical issues or unstable existing conditions, which do not typically alter the conduct of perioperative procedures or outcomes. However, these conditions are relevant to long-term patient health and should be conveyed to primary care physicians for further evaluation. FINANCIAL DISCLOSURE?: No
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