{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:27:46Z","timestamp":1777944466577,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"7-8","license":[{"start":{"date-parts":[[2021,6,26]],"date-time":"2021-06-26T00:00:00Z","timestamp":1624665600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Perioperative Practice"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:p>Elective joint arthroplasty is a commonly performed procedure with postoperative cardiovascular complications occurring in up to 3% of elderly patients. Preoperative cardiac evaluation, including transthoracic echocardiography, may improve risk stratification and optimise perioperative outcomes in patients having non-cardiac surgery.<\/jats:p>\n                  <jats:p>This study aimed to investigate the frequency, indications, appropriateness and consequences of preoperative transthoracic echocardiography in elective joint arthroplasty patients. A one-year retrospective audit was conducted for patients who had elective joint arthroplasties performed at St Vincent's Hospital Melbourne. Patient demographics, transthoracic echocardiography indication, time between transthoracic echocardiography being ordered, performed and its impact on date of surgery were obtained via database and manual chart review. Appropriateness of transthoracic echocardiography was determined in accordance with international guidelines. This study analysed 609 elective joint arthroplasties. Of these, 116 (19%) already had a recent transthoracic echocardiography. Of the remaining 493 patients, 192 (39%) received a resting transthoracic echocardiography. Only 92 (48%) of the transthoracic echocardiography\u2019s ordered were deemed appropriate. Transthoracic echocardiography resulted in a significant delay of 31 days in time to surgery.<\/jats:p>\n                  <jats:p>This study indicates that almost 40% of elective joint arthroplasty patients with no recent echocardiogram are having a resting transthoracic echocardiography as part of their preoperative assessment. In 52% of cases, these are not clearly appropriate and result in delays to surgery.<\/jats:p>","DOI":"10.1177\/1750458921996920","type":"journal-article","created":{"date-parts":[[2021,6,26]],"date-time":"2021-06-26T07:09:26Z","timestamp":1624691366000},"page":"196-201","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Appropriateness of transthoracic echocardiography in preoperative elective joint arthroplasty patients"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5737-9125","authenticated-orcid":false,"given":"Victor","family":"Yuan","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Acute Pain Medicine, St Vincent\u2019s Hospital Melbourne, Melbourne, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian S","family":"Cowie","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Acute Pain Medicine, St Vincent\u2019s Hospital Melbourne, Melbourne, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,6,26]]},"reference":[{"issue":"3","key":"bibr1-1750458921996920","first-page":"16","volume":"46","author":"Al Alawi A","year":"2016","journal-title":"Internal Medicine Journal"},{"key":"bibr2-1750458921996920","unstructured":"Australian Commission on Safety and Quality in Health Care 2018\n                      4.4 Standard echocardiography, 18 years and over\n                      Available at: www.safetyandquality.gov.au\/sites\/default\/files\/migrated\/4.4-Text-Standard-echocardiography-18-years-and-over.pdf (accessed 2 July 2019)"},{"key":"bibr3-1750458921996920","unstructured":"Australian Government Department of Health 2019\n                      Medicare benefits schedule\n                      Available at: www9.health.gov.au\/mbs\/fullDisplay.cfm?type=item&qt=ItemID&q=55113 (accessed 2 July 2019)"},{"key":"bibr4-1750458921996920","unstructured":"Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) 2018\n                      Hip, Knee & Shoulder Arthroplasty: 2018 Annual Report\n                      Available at: https:\/\/aoanjrr.sahmri.com\/documents\/10180\/576950\/Hip%2C%20Knee%20%26%20Shoulder%20Arthroplasty (accessed 2 July 2019)"},{"key":"bibr5-1750458921996920","doi-asserted-by":"publisher","DOI":"10.1002\/art.23607"},{"key":"bibr6-1750458921996920","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.06.065"},{"key":"bibr7-1750458921996920","unstructured":"British Society of Echocardiography (BSE) 2017\n                      Clinical indications for echocardiography\n                      Available at: www.bsecho.org\/common\/Uploaded%20files\/Education\/Protocols%20and%20guidelines\/Indications%20for%20echocardiography.pdf (accessed 2 July 2019)."},{"key":"bibr8-1750458921996920","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X1003800505"},{"key":"bibr9-1750458921996920","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2012.06.031"},{"key":"bibr10-1750458921996920","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2014.12.022"},{"issue":"4","key":"bibr11-1750458921996920","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1016\/j.jacc.2018.10.038","volume":"73","author":"Doherty JU","year":"2019","journal-title":"Journal of the American College of Cardiology"},{"key":"bibr12-1750458921996920","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2010.12.008"},{"key":"bibr13-1750458921996920","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.11.005"},{"key":"bibr14-1750458921996920","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000105"},{"key":"bibr15-1750458921996920","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes124"},{"issue":"35","key":"bibr16-1750458921996920","first-page":"2383","volume":"35","author":"Kristensen SD","year":"2014","journal-title":"European Society of Cardiology"},{"key":"bibr17-1750458921996920","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2003.10.002"},{"key":"bibr18-1750458921996920","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181f43149"},{"key":"bibr19-1750458921996920","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-1752"},{"key":"bibr20-1750458921996920","doi-asserted-by":"publisher","DOI":"10.1002\/ajum.12014"},{"key":"bibr21-1750458921996920","unstructured":"National Clinical Guideline Centre 2015\n                      Preoperative tests \u2013 routine preoperative tests for elective surgery\n                      . 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