We Order Too Many Preoperative Tests
As predictable as the leaves falling this time of year, another paper on the subject of unnecessary preoperative laboratory testing has appeared.
A group from the University of Texas Medical Branch looked at more than 73,000 elective hernia repairs in the National Surgical Quality Improvement Project (NSQIP) database. Almost 2/3 of the patients had preoperative laboratory tests. Of that group, 58.6 percent had a CBC, 53.5 percent had electrolytes, 23.7 percent had liver function studies, 18.7 percent had coagulation studies and 9.9 percent had all of the above. Even 54 percent of patients with no co-morbidities had at least one test.
An abnormal test was found in more than 60 percent of those tested, of the 7,200 patients who had lab tests done on the day of surgery, 61.6 percent had at least one abnormal test including 23 percent with a coagulation abnormality, 41 percent with a chemical abnormality and 33 percent with an LFT abnormality. Despite these results, the scheduled surgery was done.