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S.W. Reeves, J.M. Tielsch, J. Katz, E.B. Bass, O.D. Schein; A Self-Administered Health Questionnaire for the Preoperative Risk Stratification of Patients Undergoing Cataract Surgery . Invest. Ophthalmol. Vis. Sci. 2003;44(13):4470.
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Purpose: To determine if a self-administered health status questionnaire completed by candidates for cataract surgery can identify medical comorbidities and patients at risk for adverse intraoperative and postoperative medical events. Methods:Preoperative data were obtained from a standardized, self-administered patient health questionnaire and a history and physical form completed by the patient’s physician from a study of 19,250 cataract surgeries performed between June 1, 1995, and June 30, 1997. Adverse medical events on the day of surgery and through the first seven postoperative days were recorded. Results:Responses to 21 questions on the questionnaire were highly specific for twelve comorbid conditions identified by the physician history and physical, ranging from 100 percent specificity for arrhythmia to 91.3 percent specificity for coronary artery disease. Comorbid conditions identified by the questionnaire were associated with similar relative risks of adverse events as those identified by the physician history and physical. 35.3 percent of study participants had no comorbidities identified by the questionnaire. These subjects had medical event rates statistically indistinguishable from subjects with no comorbid conditions identified by the health provider history and physical and about 40 percent lower than the overall rate of intraoperative medical events. Conclusions:The self-administered questionnaire showed a high degree of specificity for twelve common comorbid conditions in cataract patients and identified a large proportion of subjects who were at low risk of an adverse intraoperative or postoperative event. A questionnaire such as this may be a useful preoperative risk-stratification tool for patients undergoing elective cataract surgery, identifying patients who might benefit from a separate, preoperative history and physical examination, or conversely, those who would not.
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