Related Experiment Videos
The impact of routine preoperative complete blood count (CBC) in elective operations in Srinagarind Hospital
K Bhuripanyo1, K Khumsuk, N Sornpanya
1Department of Medicine, Faculty of Medicine, Khon Kaen University, Thailand.
Insights
Routine preoperative complete blood count (CBC) tests in Thailand reveal significant abnormalities in 40.2% of patients. However, these findings altered management in only 4.0%, questioning the routine use of CBC for elective surgery patients.
Area of Science:
- Medical Diagnostics
- Surgical Pre-assessment
- Hematology
Background:
- Anemia and infectious diseases are prevalent in Thailand, leading to routine preoperative complete blood count (CBC) testing.
- There is a growing consensus questioning the clinical utility and benefit of routine preoperative CBC.
Purpose of the Study:
- To prospectively evaluate the diagnostic yield and impact on management of routine preoperative CBC in patients undergoing elective surgery.
- To identify clinical predictors of abnormal CBC results in this patient population.
Main Methods:
- Prospective study of patients scheduled for elective operations at Srinagarind Hospital.
- Collection of medical history and physical examination findings prior to CBC results.
- Analysis of CBC results and their influence on clinical management decisions.
Main Results:
- Out of 955 eligible patients, 40.2% had abnormal CBC results.
- Significant anemia (hematocrit <30%) was found in 4.4%, leukocytosis in 11.8%, and thrombocytopenia in 0.3%.
- CBC abnormalities led to a change in management for only 4.0% of patients.
Conclusions:
- While preoperative CBC abnormalities are common, they infrequently alter management in elective surgery patients.
- Clinical predictors like weight loss, fever history, anemia, and tender abdomen suggest potential CBC abnormalities.
- For patients with normal history and physical examination, the prevalence of anemia and CBCs leading to management changes is very low (<1.7%).
Abstract:
Because anemia and infectious diseases are still common, routine preoperative complete blood count (CBC) is often performed in most teaching hospitals in Thailand. However, there is growing consensus that it is of little benefit. We studied prospectively all patients who were scheduled for elective operation in Srinagarind Hospital. Medical history and physical examination were obtained prospectively without knowing the CBC result. Out of 1,013 patients interviewed, 955 were suitable for study, 384/955 (40.2%) of the CBC were abnormal. Significant anemia (hematocrit less than 30%) was found in 42 (4.4%), leukocytosis in 113 (11.8%), inadequate platelet in 3 (0.3%). The CBC abnormalities led to a change in management in 38 (4.0%). The clinical predictors of CBC abnormalities included weight loss, history of fever, presence of anemia and tender abdomen. In those with normal history and physical examination, the prevalence of anemia and CBC which led to management change was less than 1.7 per cent, regardless of age.