AB041. SOH25_AB_132. Evaluating preoperative fasting times for elective oesophagogastroduodenoscopy: a clinical audit

Background: Preoperative fasting is critical to minimize pulmonary aspiration risks during anesthesia, especially for elective oesophagogastroduodenoscopy (OGD). Current guidelines recommend fasting for solids for 6 hours and clear liquids for 2 hours before procedures. However, prolonged or inadequate fasting can lead to complications such as dehydration, hypoglycemia, and patient discomfort, particularly in elderly populations with comorbidities. This audit aimed to evaluate adherence to preoperative fasting guidelines at Portiuncula University Hospital (PUH) and identify areas for improvement to optimize patient outcomes and procedural efficiency.

Methods: This retrospective clinical audit included adult patients who underwent elective OGD between May 1 and June 30, 2024. Data were collected from medical records and patient-reported questionnaires, evaluating fasting instructions received and actual fasting durations. Compliance with guidelines was categorized as adherence (within guidelines) or non-adherence (outside guidelines). Metrics included fasting durations for solids and liquids, the time of the procedure, and patient demographics.

Results: Of 21 patients analyzed, only 14% adhered to the 6-hour fasting guideline for solids, and none adhered to the 2-hour guideline for clear liquids. Patients often fasted excessively, with durations for solids and liquids ranging from 6 to 23 hours. Morning procedures were associated with particularly prolonged fasting. Additionally, inconsistent or unclear instructions contributed to significant variability in fasting durations.

Conclusions: The audit revealed widespread non-adherence to preoperative fasting guidelines, primarily due to prolonged fasting durations and communication gaps. Standardizing fasting instructions, improving patient education, and optimizing scheduling can enhance adherence, minimize patient discomfort, and reduce complications. A re-audit is planned following the implementation of targeted interventions.

Keywords: Preoperative fasting; elective oesophagogastroduodenoscopy (elective OGD); guideline adherence; patient safety; clinical audit