Perioperative medicine & outcomes
Factors affecting adherence to recommendations on pre-operative cardiac testing: A cohort study
Authors' conclusion
Adherence to pre-operative stress imaging recommendation was high. In contrast, adherence to TTE recommendations was moderate. Both patients' and geographical factors affected adherence to joint ESC/ESA guidelines.
Study context
- Population
- Patients with elevated cardiovascular risk undergoing in-hospital elective noncardiac surgery, 25 European centres, 2017–202015,529 analysed
- Participants
- 15,983 patients
- Primary endpoint
- (Non)adherence to 2014 European Society of Cardiology (ESC)/European Society of Anaesthesiology (ESA) recommendations on pre-operative TTE and stress imaging, classified as guideline-adherent, overuse and underuse
Methodological detailsmulticentre, international
- Multicentre
- International
Primary result
As reported in the abstract
Adherence to pre-operative testing recommendations
TTE overuse (conduction in spite of class III)
16.6%
2542/15 344
TTE underuse (nonconduction in spite of class I recommendation)
6.6%
1015/15 344
Stress imaging overuse
1.7%
241/14 202
Stress imaging underuse
0.4%
52/14 202
Further findings
Factors associated with nonadherence (multivariate multinomial regression)
- Male sex, some age categories and some geographical regions significantly associated with TTE overuse
- Male sex and some regions associated with TTE underuse
- Age and regions associated with overuse of stress imaging
- Male sex, age, and some regions associated with stress imaging underuse
Original publication
Factors affecting adherence to recommendations on pre-operative cardiac testing: A cohort study. Eur J Anaesthesiol. Published 10 July 2024. doi:10.
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