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Related Experiment Videos

Routine pre-operative blood testing: is it necessary?

R K Johnson1, A J Mortimer

  • 1Departments of Surgery and Anaesthesia, Wythenshawe Hospital, South Manchester University Hospitals Trust, Southmoor Road, Wythenshawe, Manchester M23 9LT, UK. marie.oliver@smuht.nwest.nhs.uk

Anaesthesia
|August 23, 2002
PubMed
Summary

Routine pre-operative screening tests rarely alter patient management or predict complications. Selective ordering of these investigations could significantly reduce healthcare costs.

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Area of Science:

  • Anesthesiology
  • Surgical Patient Management
  • Health Economics

Background:

  • Routine pre-operative investigations are standard practice before elective surgery.
  • The clinical utility and cost-effectiveness of these tests are often debated.
  • Optimizing pre-operative assessment is crucial for patient safety and resource allocation.

Purpose of the Study:

  • To evaluate the value of routine pre-operative screening investigations.
  • To assess the impact of abnormal test results on peri-operative management.
  • To determine the cost savings associated with selective pre-operative testing.

Main Methods:

  • Prospective audit of 100 patients undergoing elective surgery under general anesthesia.
  • Analysis of pre-operative screening tests: full blood count, urea and electrolytes, random glucose.

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  • Examination of test result availability, abnormality rates, and impact on peri-operative management.

    • Main Results:

    • 773 tests were performed, with 70 (9.1%) abnormal results.
    • Peri-operative management was altered in only 2 cases (0.2%) due to abnormal results.
    • Test results were available in medical notes for only 57% of patients at the time of surgery.

    Conclusions:

    • Routine pre-operative screening investigations have limited impact on peri-operative management.
    • Selective ordering of pre-operative tests can lead to substantial cost savings.
    • Current pre-operative testing strategies may not be cost-effective or clinically justified.