Display options
Cite
Rafiq MS, Rafiq M, Rafiq MI, et al. Doing Pre-operative Investigations in Emergency Department; a Clinical Audit. Emerg (Tehran). 2017;5(1):e20
Rafiq, M. S., Rafiq, M., Rafiq, M. I., Salman, S. G., & Hafeez, S. (2017). Doing Pre-operative Investigations in Emergency Department; a Clinical Audit. Emergency (Tehran, Iran), 5(1), e20.
Rafiq, Muhammad Salman, et al. "Doing Pre-operative Investigations in Emergency Department; a Clinical Audit." Emergency (Tehran, Iran) vol. 5,1 (2017): e20.
Rafiq MS, Rafiq M, Rafiq MI, Salman SG, Hafeez S. Doing Pre-operative Investigations in Emergency Department; a Clinical Audit. Emerg (Tehran). 2017;5(1):e20. Epub 2017 Jan 09. PMID: 28286827; PMCID: PMC5325889.
Copy Download .nbib Format: NLM
Share it on

Emerg (Tehran). 2017;5(1):e20. Epub 2017 Jan 09.

Doing Pre-operative Investigations in Emergency Department; a Clinical Audit.

Emergency (Tehran, Iran)

Muhammad Salman Rafiq, Maria Rafiq, Muhammad Imran Rafiq, Seema Gul Salman, Sania Hafeez

Affiliations

  1. Department of Surgery, Khyber Teaching Hospital, Peshawar, Pakistan.
  2. Department of Obstetrics and Gynecology, Khyber Teaching Hospital, Peshawar, Pakistan.
  3. Department of Cardiology, Khyber Teaching Hospital, Peshawar, Pakistan.
  4. Department of Obstetrics and Gynecology, Mardan Medical Complex, Mardan, Pakistan.
  5. Department of Obstetrics and Gynecology, Hayatabad Medical Complex, Peshawar, Pakistan.

PMID: 28286827 PMCID: PMC5325889

Abstract

INTRODUCTION: Pre-operative investigations for emergency surgical patients differ between centers. Following established guidelines can reduce unnecessary investigation, cost of treatment and hospital stay. The present audit was carried out to evaluate the condition of doing pre-operative investigations for three common surgical emergencies compared to National Institute for Health and Care Excellence (NICE) guidelines and local criteria.

METHODS: A retrospective clinical audit of acute-appendicitis, abscess and hernia patients admitted to the emergency department was carried out over a one-year period from July 2014 to July 2015. Data of laboratory investigations, their indication, cost and duration of hospital stay was collected and compared with NICE-guidelines.

RESULTS: A total of 201 patients were admitted to the emergency department during the audit period. These included 77(38.3%) cases of acute-appendicitis, 112 (55.7%) cases of abscesses, and 12 (6%) cases of hernia. Investigations not indicated by NICE-guidelines included 42 (20.9%) full blood counts, 29 (14.4%) random blood sugars, 26 (12.9%) urea tests, 4 (2%) chest x-rays, 13 (6.5%) electrocardiographs, and 58 (28.9%) urine analyses. These cost 25,675 Rupees (245.46 Dollars) in unnecessary investigation costs and 65.7 days of additional hospital stay.

CONCLUSIONS: Unnecessary investigations for emergency surgical patients can be reduced by following NICE-guidelines. This will reduce workload on emergency services, treatment costs and the length of hospital stay.

Keywords: Clinical audit; emergencies; emergency treatment; management audit

Conflict of interest statement

We wish to confirm that there are no known conflicts of interest associated with this publication.

References

  1. J Pak Med Assoc. 2002 Mar;52(3):95-100 - PubMed
  2. Am J Surg. 2007 Jan;193(1):55-60 - PubMed
  3. Hippokratia. 2007 Jan;11(1):13-21 - PubMed
  4. Int J Cardiol. 2015;187:600-3 - PubMed
  5. Postgrad Med J. 2006 Dec;82(974):823-9 - PubMed
  6. Postgrad Med J. 1995 Feb;71(832):81-5 - PubMed
  7. Clin Chem. 1990 Dec;36(12):2151-2 - PubMed
  8. Health Technol Assess. 2012 Dec;16(50):i-xvi, 1-159 - PubMed
  9. J Family Med Prim Care. 2014 Apr;3(2):171-2 - PubMed

Publication Types