Effective Test Utilization Recommendations

Avoid routine preoperative testing for low risk surgeries without a clinical indication

General Lab
Most preoperative tests (typically a complete blood count, Prothrombin Time and Partial Prothomboplastin Time, basic metabolic panel and urinalysis) performed on elective surgical patients are normal. Findings influence management in under 3% of patients tested. In almost all cases, no adverse outcomes are observed when clinically stable patients undergo elective surgery, irrespective of whether an abnormal test is identified. Preoperative testing is appropriate in symptomatic patients and those with risks factors for which diagnostic testing can provide clarification of patient surgical risk.

REFERENCES

  1. Keay L, Lindsley K, Tielsch J, Katz J, Schein O. Routine preoperative medical testing for cataract surgery. Cochrane Database of Systematic Reviews. 2012, Issue 3. Art. No.: CD007293. DOI: 10.1002/14651858.CD007293.pub3.
  2. Katz R, Dexter F, Rosenfeld K, Wolfe L, Redmond V, Agarwal D, Salik I, Goldsteen K, Goodman M, Glass PS. Survey study of anesthesiologists’ and surgeons’ ordering of unnecessary preoperative laboratory tests. Anesth Analg. 2011 Jan;112(1).
  3. Munro J, Booth A, Nicholl J. Routine preoperative testing: A systematic review of the evidence. Health Technol Assessmen. 1997;1(12).
  4. Reynolds TM. National Institute for Health and Clinical Excellence guidelines on preoperative tests: The use of routine preoperative tests for elective surgery. Ann Clin Biochem [Internet]. 2006 Jan [cited 2012 Oct 12];43:13-16.
  5. Capdenat Saint-Martin E, Michel P, Raymond JM Iskandar H, Chevalier C, Petitpierre MN, Daubech L, Amouretti M, Maurette P. Description of local adaptation of national guidelines and of active feedback for rationalizing preoperative screening in patients at low risk from anaesthetics in a French university hospital. Qual Health Care [Internet]. 1998 Mar [cited 2012 Oct 12];7:5-11.
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