Effectiveness and Safety of Nurse Anesthetist-Led Preanesthesia Evaluation for Patients With Cancer: A Retrospective Observational Study With Coarsened Exact Matching Method.

PURPOSE: To investigate the effectiveness and safety of nurse anesthetist-led preanesthesia evaluation in patients with cancer.

DESIGN

A retrospective observational study with a historical comparison group.

METHODS

Data of patients with cancer and undergoing surgery and preanesthesia evaluation 1 year before and after the implementation of nurse anesthetist-led preanesthesia evaluation were collected from electronic medical systems. A coarsened exact matching approach was applied to match the pre- and post groups based on eight characteristic variables. The Student t test and the χ2 test were used for data analysis.

FINDINGS: After matching, 8,393 patients both in the exposure and comparison groups were analyzed. The proportion of preanesthesia assessments completed before the day of surgery increased from 41.5% to 96.8%; the total number of cancellations of surgery decreased from 30 (0.36%) to 9 (0.11%) with substantial declines in procedure cancellations due to arrhythmia (10, 0.12% vs 0, 0%) and incomplete preoperative investigations (12, 0.14% vs 2, 0.02%). Unplanned stay in the postanesthesia care unit longer than 2 hours significantly decreased from 176 (2.1%) to 139 (1.66%). Other anesthesia-related outcomes were not significantly different.

CONCLUSIONS

Nurse anesthetist-led preanesthesia evaluation for cancer patients was effective and safe. Future studies should use a more rigorous study design or a parallel comparison to strengthen the findings in this area.