Importance of Routine Laboratory Investigations Before Elective Surgery

Area of Science:

• Anesthesiology
• Laboratory Medicine
• Health Economics

Background:

• Routine pre-operative laboratory investigations are standard practice before elective surgeries.
• The clinical utility and cost-effectiveness of these tests are often debated.

Purpose of the Study:

• To assess the value of routine pre-operative tests in American Society of Anesthesiologists (ASA) Grade I and II adults undergoing elective surgery.
• To evaluate the influence of these tests on anesthetic management and associated costs.

Main Methods:

• 1271 patients undergoing elective surgery were recruited.
• Clinical evaluation and laboratory investigations were performed.
• Data on test results, peri-operative interventions, and costs were recorded.

Main Results:

• Only 4.37% of routine tests showed abnormalities, with 4.15% clinically suspected.
• Peri-operative intervention was required in only 0.43% of patients.
• Abnormal tests contributed only 6.9% to the total investigation cost.

Conclusions:

• The incidence of abnormal pre-operative test results impacting anesthetic management was very low (<1%).
• Most pre-operative testing costs (93%) were associated with normal results.
• Judicious advising of pre-operative investigations is recommended to minimize costs and delays.