Preoperative work up: are the requirements different in a developing country?

Area of Science:

• General Surgery
• Internal Medicine
• Diagnostic Testing

Background:

• Routine laboratory testing is often advocated for asymptomatic patients in developing countries to detect underlying medical conditions.
• Preoperative investigations aim to identify conditions that may affect surgical outcomes.

Purpose of the Study:

• To evaluate the utility of routine preoperative laboratory investigations in asymptomatic patients undergoing general surgery.
• To determine the prevalence of significant medical conditions identified through preoperative testing in this population.

Main Methods:

• A retrospective review of 320 patients' case notes from the General Surgical department was conducted.
• Patients were selected based on common general surgical procedures.
• Laboratory results and patient histories/physical examinations were analyzed.

Main Results:

• Of 216 asymptomatic patients, 19.4% had low hemoglobin, and 10.6% had abnormal chest X-rays.
• Other abnormalities like hypokalemia (4.8%) and raised blood sugar (0.88%) were less common.
• Only one patient required preoperative intervention due to severe anemia; other abnormalities did not impact treatment or outcome.

Conclusions:

• Thorough patient history and physical examination are reliable and cost-effective preoperative screening tools.
• Routine laboratory investigations may not be necessary for all asymptomatic American Society of Anesthesiologists Grade I (ASA I) patients.
• Guidelines for preoperative investigations should be reconsidered, particularly for low-risk surgical patients.