Evaluation of routine preoperative testing practices in Sudanese public hospitals 2024: a multicenter prospective study.

Abstract

Background: The practice of routine preoperative testing is common in clinical settings despite the presence of regulatory guidelines, straining patients financially and further delaying delivery of care. This study aimed to assess the practice of routine preoperative investigations and compliance with the National Institute for Health and Care Excellence (NICE) guidelines for preoperative investigations in Sudan.

Methods: A prospective multicenter study was conducted in the main public hospitals at Atbara, Shendi, and Port-Sudan in January 2024; we prospectively studied 90 adults, sampled by covering all consecutive patients who underwent elective operations during the study period. Data were collected during the preanesthetic check-up and evaluated by senior clinicians for compliance with the NICE guidelines.

Results: The study included 39 females (43%) and 51 males (56%), with a mean age of 38 ± 14 years. Among the 90 patients, 89 (99%) underwent at least one unnecessary investigation. Overall, out of 586 requested investigations preoperatively, 312 (53.2%) were unnecessary according to the NICE guidelines. The predictors of requesting unnecessary investigations were ASA status (p value 0.020) and surgery grade (< 0.001).

Conclusion: This study reported significant overutilization of preoperative testing in Sudanese public hospitals. To address this issue, it is crucial to acknowledge widely recognized guidelines, raise clinicians' awareness of them and monitor their implementation.