Utility of routine laboratory preoperative tests based on previous results: Time to give up
| Autor: | Enrique Rodriguez-Borja, Arturo Carratala-Calvo, Gerardo Aguilar-Aguilar, Africa Corchon-Peyrallo |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Pathology cost-effectiveness preoperative care patient safety routine diagnostic tests Adolescent Cost effectiveness Cost-Benefit Analysis Clinical Biochemistry Short Communications Preoperative care 03 medical and health sciences Patient safety Young Adult 0302 clinical medicine 030202 anesthesiology medicine Coagulation testing Humans Medical history Child Aged Retrospective Studies Aged 80 and over business.industry Diagnostic Tests Routine General surgery Medical record Biochemistry (medical) Retrospective cohort study Middle Aged Test (assessment) Child Preschool Female business 030217 neurology & neurosurgery |
| Zdroj: | Biochemia Medica r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA instname Volume 27 Issue 3 |
| ISSN: | 1330-0962 1846-7482 |
| Popis: | Introduction The usefulness and cost-effectiveness of routine laboratory preoperative tests (POTs) have been challenged recently. In fact, the American Society of Anesthesiologists (ASA) Task Force has stated that test results obtained from the medical record within 6 months of surgery generally are mostly acceptable. The aim of our study was to evaluate the degree of utility of POTs and their clinical benefit based on this recommendation. Material and methods We studied retrospectively every routine POT request from 8 randomly selected weeks in 2016. Every POT contained glucose, creatinine, haemoglobin and coagulation tests (PT-INR). Each pathological result for these tests was registered and classified as "expected" (if previous pathological result within 6 months existed for that test) or "unexpected" (if previous pathological result within 6 months did not exist for that test). Results of ASA physical status classification (a system for assessing the fitness of patients before surgery) and changes in patient management after POTs were retrieved from medical history as well. Results A total of 4516 tests (from 1129 patients) were analysed and 498 results were found pathological (11%). Of these, 403 were expected (8.9%) and 95 unexpected (2.1%). There was not any change in anaesthetic management for any patient due to these findings. Conclusions Routine POTs are an inefficient and low-value service. POTs have to be always ordered selectively after a previous consideration of specific information obtained from several sources (medical records, interviews, examinations, type of surgery) and only if the information obtained will result in changes in the management of the patient. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|