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Related Experiment Videos

Preoperative screening: value of previous tests.

D S Macpherson1, R Snow, R P Lofgren

  • 1University of Minnesota, Minneapolis.

Annals of Internal Medicine
|December 15, 1990
PubMed
Summary
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Preoperative screening tests may be safely substituted with prior normal test results, reducing duplication. Only a small fraction of normal prior tests became abnormal, often predictable and unaddressed.

Area of Science:

  • Clinical Pathology
  • Surgical Pre-assessment
  • Health Services Research

Background:

  • Routine preoperative laboratory testing is common practice.
  • The utility and cost-effectiveness of repeated preoperative tests are debated.
  • Previous normal test results may offer valuable information for perioperative management.

Purpose of the Study:

  • To assess the frequency of laboratory tests performed within a year before elective surgery.
  • To evaluate the rate of change in test results from normal to abnormal values that could impact perioperative management.
  • To determine if prior normal test results can substitute for routine preoperative screening.

Main Methods:

  • Retrospective cohort analysis of computerized laboratory data.

Related Experiment Videos

  • Included complete blood count, electrolytes (sodium, potassium), creatinine, prothrombin time, and partial thromboplastin time.
  • Analyzed data from 1109 patients undergoing elective surgery at a tertiary care Veterans Affairs hospital in 1988.

    • Main Results:

    • 47% of 7549 preoperative tests duplicated tests from the previous year.
    • Only 0.4% of prior normal test results (n=3096) became abnormal, often predictably.
    • 17% of prior abnormal test results (n=461) remained abnormal or changed significantly.

    Conclusions:

    • Prior normal laboratory test results can be safely used as a substitute for preoperative screening tests.
    • Substitution is appropriate when tests are normal and no clear indication for retesting exists.
    • This approach may reduce unnecessary testing and associated healthcare costs.