Featured Research

from universities, journals, and other organizations

Patients can safely skip pre-surgery stress tests and beta blockers, study suggests

Date:
December 11, 2009
Source:
University of Michigan Health System
Summary:
Physicians should "throttle back" from routinely ordering stress tests and prescribing beta blockers to patients before noncardiac surgeries, according to a new report. Studies suggest such pre-operative tests and medications do not save lives and patients can skip them without suffering complications later.

Physicians should "throttle back" from routinely ordering stress tests and prescribing beta blockers to patients before non-cardiac surgeries, according to a report by the University of Michigan recently released online.

Related Articles


Studies suggest such pre-operative tests and medications do not save lives and patients can skip them without suffering complications later, the U-M physicians write in a special report released ahead of print in Annals of Internal Medicine.

The article by U-M physicians appears as the American College of Cardiology and American Heart Association release new guidelines showing pre-operative medications should be reserved for only high risk patients undergoing complicated surgeries.

But U-M physicians go a step further by critically evaluating other costly pre-operative practices -- stress testing and coronary revascularizations such as stenting and bypass surgery for patients with stable heart disease.

These patients do not benefit from revascularization as studies show that it may trigger as many events as it prevents.

"Physicians may struggle with implementing these evidence-based guidelines for a variety of reasons, including legal concerns regarding pre-operative cardiac events, pressure from surgical colleagues and reliance on testing and procedures for income," says senior author Kim Eagle, M.D., director of the U-M Cardiovascular Center and the Albion Walter Hewlett Professor of Internal Medicine.

"It's imperative that any form of health care reform provide incentives to follow these guidelines," Eagle says. "It is the quality of care, not the quantity of tests, that matters most."

Eagle and his U-M colleagues describe screening patients with stable cardiac disease before non-cardiac surgeries such as hip replacement and gallbladder surgery as a failed strategy.

Stress tests do not reliably predict potentially fatal issues such as coronary artery clots and spasms, and beta blockers can harm patients whose heart disease is stable if dosages are not carefully monitored over months. Most patients are given the new medications in the days and weeks before surgery and before they can have a significant impact on relieving stress on the heart.

"Traditionally we've thought of stress tests as the best way to figure out whether a patient is ready for surgery," says Vineet I. Chopra, M.D., a hospitalist at UMHS and clinical assistant professor of internal medicine at the U-M Medical School.

"It appears that many noninvasive stress tests are not only unnecessary, but potentially misleading," Chopra says. "Occasionally such testing may lead to unnecessary invasive testing which has its own set of risks, or unnecessary medical treatment which also has some risks attached," he says.

The new ACC/AHA guidelines on beta blockers advise doctors to identify the correct patients for medical therapy, rather than use a one-size fits all approach. Broad recommendations to treat all diabetics and those with high blood pressure with the medications before surgery are no longer the case, Chopra says.


Story Source:

The above story is based on materials provided by University of Michigan Health System. Note: Materials may be edited for content and length.


Journal Reference:

  1. Vineet Chopra, M.D., Scott A. Flanders, M.D., James B. Froehlich, M.D., MPH; Wei C. Lau, M.D., and Kim A. Eagle. Perioperative Practice: Time to Throttle Back. Annals of Internal Medicine, December 1, 2009

Cite This Page:

University of Michigan Health System. "Patients can safely skip pre-surgery stress tests and beta blockers, study suggests." ScienceDaily. ScienceDaily, 11 December 2009. <www.sciencedaily.com/releases/2009/12/091202153948.htm>.
University of Michigan Health System. (2009, December 11). Patients can safely skip pre-surgery stress tests and beta blockers, study suggests. ScienceDaily. Retrieved October 25, 2014 from www.sciencedaily.com/releases/2009/12/091202153948.htm
University of Michigan Health System. "Patients can safely skip pre-surgery stress tests and beta blockers, study suggests." ScienceDaily. www.sciencedaily.com/releases/2009/12/091202153948.htm (accessed October 25, 2014).

Share This



More Health & Medicine News

Saturday, October 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

IKEA Desk Converts From Standing to Sitting With One Button

IKEA Desk Converts From Standing to Sitting With One Button

Buzz60 (Oct. 24, 2014) IKEA is out with a new convertible desk that can convert from a sitting desk to a standing one with just the push of a button. Jen Markham explains. Video provided by Buzz60
Powered by NewsLook.com
Ebola Protective Suits Being Made in China

Ebola Protective Suits Being Made in China

AFP (Oct. 24, 2014) A factory in China is busy making Ebola protective suits for healthcare workers and others fighting the spread of the virus. Duration: 00:38 Video provided by AFP
Powered by NewsLook.com
WHO: Millions of Ebola Vaccine Doses by 2015

WHO: Millions of Ebola Vaccine Doses by 2015

AP (Oct. 24, 2014) The World Health Organization said on Friday that millions of doses of two experimental Ebola vaccines could be ready for use in 2015 and five more experimental vaccines would start being tested in March. (Oct. 24) Video provided by AP
Powered by NewsLook.com
Doctor in NYC Quarantined With Ebola

Doctor in NYC Quarantined With Ebola

AP (Oct. 24, 2014) An emergency room doctor who recently returned to the city after treating Ebola patients in West Africa has tested positive for the virus. He's quarantined in a hospital. (Oct. 24) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins