Usefulness of routine preoperative testing in a developing country: a prospective study

Area of Science:

• Anesthesiology
• Global Health
• Preoperative Medicine

Background:

• Preoperative evaluation is crucial for assessing anesthetic risks.
• Developing countries face challenges in preanesthesia evaluation due to limited medical history and language barriers.
• Routine preoperative testing's impact in low-resource settings requires evaluation.

Purpose of the Study:

• To evaluate the impact of routine preoperative testing in a low-resource setting.
• To assess the frequency of abnormal findings and their effect on surgical scheduling.

Main Methods:

• Prospective observational study in a French surgical unit in Abidjan, Ivory Coast.
• Screened 201 patients scheduled for non-urgent surgery with routine laboratory exams.
• Assessed changes in surgery (delayed or scheduled) based on test results.

Main Results:

• Abnormal hemoglobin found in 35% of patients, abnormal white blood cell (WBC) count in 11.1%, and abnormal platelets in 15.3%.
• Positive Human Immunodeficiency Virus (HIV) results detected in 8.3% of cases.
• Routine tests accounted for 43.6% of reasons for surgical changes.

Conclusions:

• Routine preoperative tests identified abnormal results in up to 35% of cases in a developing country.
• These tests contributed to 43.5% of delayed surgeries.
• Selected tests could be beneficial for diagnosing conditions requiring pre-surgical treatment, but cost-benefit and clinical impact require further study.