• S Singh and M Manji.
• Department of Anaesthesia, Selly Oak Hospital, University Hospital NHS Trust, Birmingham B29 6JD, UK. sukbinder.singh@virgin.net
• Anaesthesia. 2001 Oct 1;56(10):988-90.

AbstractPre-operative optimisation of high-risk patients undergoing major elective surgery has been shown to decrease peri-operative morbidity and mortality. It is also cost effective because of the resulting decrease in postoperative complications. A questionnaire was sent to 170 intensive care and high dependency units in Britain in order to quantify the number of units practising pre-operative optimisation. There was a 91% response rate. Of the respondents familiar with the evidence advocating pre-operative optimisation, 91% believe pre-operative optimisation improves outcome but only 62% admit patients for such preparation. Moreover, only eight units (6%) admit more than 25% of eligible patients. The reasons given for not admitting such patients pre-operatively are a lack of manpower, beds or both. This survey demonstrates the need for greater investment of resources into intensive care and high dependency units, so that clinicians can deliver high-quality evidence-based healthcare in accordance with the principles of clinical governance.

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