A clinical pathway to improve surgical risk assessment and use of perioperative β blockade in noncardiac surgery patients

Academic Article


  • • Objective: To assess the impact of a clinical pathway for operative risk assessment designed to increase the appropriate use of perioperative β blockers. • Design: Retrospective cohort study. • Patients and setting: Charts of patients who underwent outpatient perioperative risk assessment at a university primary care clinic 7 days or less before elective surgery were selected and reviewed. Data were obtained from 100 preintervention and 61 post-intervention patients. • Measures: Rates of documentation of surgical risk factors, documentation of risk for perioperative cardiac events, and appropriate use of perioperative β-blocker therapy. • Results: The postintervention group had higher rates of documentation of surgical risk factors (79% versus 59%; P = 0.01) and cardiac event risk factors (82% versus 36%; P < 0.001) compared with the preintervention group. Among the 53 patients who met the pathway criteria for β-blocker therapy, those in the postintervention group were more likely to have β-blocker therapy initiated at the time of the risk-assessment visit (42% versus 0% preintervention; P < 0.001) and to receive perioperative β-blocker therapy overall (73% versus 41% preintervention; P = 0.013). • Conclusion: This clinical pathway improves documentation of surgical risk and recognition of patient risk factors for perioperative cardiac events and increases appropriate use of perioperative β blockers in patients who undergo elective noncardiac surgery.
  • Published In

  • JCOM  Journal
  • Author List

  • Robinson RL; Rogers LQ; Todd CY; Bussing RC
  • Start Page

  • 429
  • End Page

  • 433
  • Volume

  • 11
  • Issue

  • 7