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An audit of pre-operative medical investigations among healthy adults undergoing elective cataract surgery in south western nigeria

Authors:Bola Josephine Adekoya, Adebowale Olayinka Adekoya, Uzoma Pauline Okeke
Int J Biol Med Res. 2011; 2(4): 1153 – 1157  |  PDF File

Abstract

Aim – To determine the types and frequency of abnormal results from medical investigations ordered in adults being prepared for cataract surgery. Methods: A retrospective review of case files and theatre records was done of all adult patients who had cataract surgery over a one year period. The number, type, and results of pre-operative investigations were extracted from the case files. Frequency tables were generated and chi square (Fisher’s exact with variables less than 5) was used to examine association between variables. Results: There were 62 (45.3%) women, and majority 131 (95.6%) of the surgery were extra-capsular cataract extractions. The maximum and minimum number of tests ordered were 6 and 2 respectively. Fasting blood sugar and screening for human immunodeficiency virus were conducted in all patients, and showed abnormalities in 7 (5.1%) and 1 (0.7%) patients respectively. 47.1% of the patients had heamatocrit levels outside the normal reference values. Patients that were 50 years and above were more likely to have had more than three tests done (OR=5.9 (95% CI; 2.1, 17.8). Abnormal fasting blood sugar and urine results lead to postponement of surgery, while others did not. Conclusions: Investigations were ordered routinely and at random, and some did not reveal any new information nor alter the course of management. Therefore, investigations should be tailored according to the patient’s history and examination findings. Also, universal precautions and measures should be adopted in all patients as a way of preventing transfer of infection (especially human immunodeficiency virus) from patient to surgeon.