Preoperative laboratory testing in elderly patients

Area of Science:

• Geriatric Medicine
• Clinical Chemistry
• Surgical Outcomes

Background:

• Preoperative assessment is crucial for elderly patients to evaluate surgical risks.
• Identifying vulnerabilities aids in predicting and preventing postoperative complications.
• This review focuses on the role of laboratory tests in geriatric preoperative evaluations.

Purpose of the Study:

• To review preoperative laboratory tests used in geriatric patients.
• To identify laboratory markers that predict postoperative complications in the elderly.
• To inform preoperative care planning for older adults.

Main Methods:

• Systematic review of literature on preoperative laboratory testing in geriatric patients.
• Analysis of studies correlating specific laboratory values with postoperative outcomes.
• Identification of predictive biomarkers for complications such as cognitive dysfunction, cardiac events, and acute kidney injury.

Main Results:

• Complete blood count, electrolytes, and blood chemistry predict general postoperative complications.
• Salivary cortisol ratio, C-reactive protein/albumin ratio (CAR), neutrophil/lymphocyte ratios, albumin, and 25-hydroxyvitamin D predict postoperative cognitive dysfunction.
• Brain-natriuretic peptide and alkaline phosphatase indicate cardiac events; estimated glomerular filtration rate and albumin predict acute kidney injury.
• Hyponatremia, hypocalcemia, low albumin/fibrinogen ratio, and hypoalbuminemia are associated with complications like surgical site infection and mortality.

Conclusions:

• Preoperative laboratory testing is valuable for predicting adverse postoperative outcomes in elderly patients.
• Specific biomarkers can identify risks for cognitive dysfunction, cardiac events, kidney injury, infection, and mortality.
• Results support the initiation of targeted care plans based on preoperative laboratory findings.