Utilization of Preoperative Laboratory Testing for Low-risk, Ambulatory Urologic Procedures
| Autor: | Wilson Sui, Marissa C. Theofanides, Justin T. Matulay, Maxwell B. James, Ifeanyi C. Onyeji, Arindam RoyChoudhury, Matthew Rutman |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Multivariate analysis Urology Risk Assessment Laboratory testing 03 medical and health sciences Postoperative Complications 0302 clinical medicine Preoperative Care Humans Medicine Clinical significance 030212 general & internal medicine Retrospective Studies Clinical Laboratory Techniques business.industry Middle Aged Urethral Sling Acs nsqip Surgery Ambulatory Surgical Procedures 030220 oncology & carcinogenesis Ambulatory Urologic Surgical Procedures Complication business American society of anesthesiologists |
| Zdroj: | Urology. 94:77-84 |
| ISSN: | 0090-4295 |
| DOI: | 10.1016/j.urology.2016.03.053 |
| Popis: | Objective To determine the clinical significance of preoperative laboratory testing for low-risk ambulatory urologic procedures. Materials and Methods The National Surgical Quality Improvement Program (NSQIP) database from 2005 to 2013 was queried for urethral sling procedures, cystoscopic procedures, and scrotal procedures. Multivariate analysis was used to assess for independent predictors of preoperative laboratory testing utilization and for postoperative complications. Results Overall, 7378 procedures were identified, with 73.9% undergoing 1 or more laboratory tests, including 37.9% who had no comorbidities. Patients who were tested were older, had a higher American Society of Anesthesiologists class, and had more preoperative comorbidities. Of these procedures, only 2.9% resulted in any complication. Most laboratory tests were drawn within 1 week of the procedure. On multivariate analysis of testing utilization, increasing age and medical comorbidities were predictive of testing. Multivariate analysis of postoperative outcomes showed that abnormal test laboratory findings were not predictive of postoperative complications in those with and without NSQIP-defined comorbidities. Conclusion Abnormal preoperative laboratory testing was not a significant independent predictor of postoperative complications. Almost 40% of patients received preoperative testing despite having no NSQIP-detected comorbid conditions. A multidisciplinary approach should be taken to define procedures in which preoperative laboratory testing may be eliminated. |
| Databáze: | OpenAIRE |
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