順天堂醫事雑誌
Online ISSN : 2188-2126
Print ISSN : 2187-9737
ISSN-L : 2187-9737

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Introduction of a Multidisciplinary Preoperative Clinic at Juntendo University Hospital - A Retrospective Observational Study Focusing on Effects of Preoperative Interventions on Clinical Outcomes
YUKI UMENOSEIJI ISHIKAWA OSAMU KUDOHSHUKO NOJIRIGAUTAM DESHPANDEEIICHI INADAMASAKAZU HAYASHIDA
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ジャーナル オープンアクセス 早期公開

論文ID: JMJ23-0023-OA

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Objectives To investigate the effects of interventions provided by a multidisciplinary team consisting of anesthesiologists, dentists, pharmacists, and nurses at a Preoperative Clinic (POC) on postoperative outcomes.

Methods We retrospectively investigated patients who underwent preoperative evaluation at the POC at Juntendo University Hospital between May and July, 2019. Patients were divided into intervention and non-intervention groups according to whether they received intervention(s) at the POC or not. Postoperative outcomes were compared between the groups, before and after propensity score (PS) matching.

Results We investigated 909 patients who completed POC evaluation and underwent surgery. Patients in the intervention group (n = 455 [50.1%]) received at least one intervention delivered, in the order of higher delivery frequencies, by dentists, pharmacists, nurses, and anesthesiologists. Before PS matching, the intervention group was associated with older age, more frequent cardiovascular comorbidities, and higher ASA-PS grades than the non-intervention group, while neither frequencies nor severities of postoperative complications differed between the groups. These outcomes did not differ between 382 PS-matched pairs with comparable risk factors either.

Conclusions Before PS matching, postoperative outcomes did not differ between the groups, although the intervention group was associated with higher risks. These suggested that POC interventions could have improved postoperative outcomes in the higher-risk intervention group to the same level as in the non-intervention group. However, such potential beneficial effects of interventions could not be proven after PS matching. Further studies are required to elucidate effects of POC interventions on postoperative outcomes.

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© 2023 The Juntendo Medical Society. This is an open access article distributed under the terms of Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original source is properly credited.

This article is licensed under a Creative Commons [Attribution 4.0 International] license.
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