Virtual preoperative assessment in surgical patients: A systematic review and meta-analysis

Study objective: Preoperative assessment is a standard evaluation, traditionally done in-person in a preanesthesia clinic, for patients who will be undergoing a procedure involving anesthesia. Given the increased adoption of virtual care during the coronavirus disease 2019 (COVID-19) pandemic, the purpose of this systematic review and meta-analysis is to review the effectiveness of virtual preoperative assessment for the evaluation of surgical patients. Design: Systematic review and meta-analysis. Setting: MEDLINE (Ovid), MEDLINE InProcess/ePubs, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and ClinicalTrials.gov were searched from the initial coverage of the respective database to May 2021. A manual citation search of Google Scholar and PubMed was conducted to identify missed articles. Continued literature surveillance was done through July 2021. Patients: Patients aged 18 years and older undergoing virtual preoperative anesthesia assessment. Interventions: Virtual preoperative assessment. Measurements: Surgery cancellation rates, patient experience, resources saved, staff experience, success in using the data collected to diagnose and manage patients. Main results: Fifteen studies (n = 31,496 patients) were included in this review. The average age of patients was 58 +/- 15 years, and 47% were male. Virtual preoperative assessment resulted in similar surgery cancellation rates compared to in-person evaluation, with a pooled cancellation rate of 2% (95% confidence interval [CI]: 1-3%). Most studies reported a positive patient experience, with a pooled estimate of 90% (95% CI, 81-95%). There was a high success rate in using the information collected with virtual care, in the range of 92-100%, to diagnose and manage patients resulting in time and cost savings in the range of 24-137 min and $60-67 per patient. Conclusions: This systematic review and meta-analysis demonstrates the utility of virtual care for preoperative assessment of surgical patients. Virtual preanesthesia evaluation had similar surgery cancellation rates, high patient satisfaction, and reduced costs compared to in-person evaluation.

Automated summary

The systematic review and meta-analysis show that virtual care for preoperative assessment of surgical patients is effective, with similar surgery cancellation rates, high patient satisfaction, and cost savings compared to in-person evaluation.