A self-administered health questionnaire for the preoperative risk stratification of patients undergoing cataract surgery.
PURPOSE: To determine if a self-administered health status questionnaire completed by candidates for cataract surgery is beneficial for identifying medical comorbidities and patients at risk for adverse intraoperative and postoperative medical events. DESIGN: Prospective cohort study. METHODS: Data were obtained from a large, randomized clinical trial of 19,250 cataract surgeries performed between June 1, 1995, and June 30, 1997. Preoperative data were obtained from a standardized, self-administered patient health questionnaire and a history and physical form completed by the patient's physician. A record of adverse medical events on the day of surgery and through the first 7 postoperative days was recorded. RESULTS: Responses to 21 questions on the questionnaire were highly specific for 12 comorbid conditions identified by the physician history and physical, ranging from 100% specificity for arrhythmia to 91.3% specificity for coronary artery disease. Comorbid conditions identified by the questionnaire were associated with similar relative risks of adverse events as those identified by the physician history and physical. Patients who had no comorbidities identified by the questionnaire had adverse medical event rates indistinguishable from patients with no comorbid conditions identified by the health provider history and physical. CONCLUSIONS: The self-administered questionnaire showed a high degree of specificity for 12 common comorbid conditions in cataract patients. A questionnaire such as this may be useful in preoperative risk stratification.